Organization
A W KELLY DDS PLLC
Active
Other names
Dental Center of the Carolinas
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW WAYNE KELLY DDS (OWNER/ MANAGER)
(336) 766-7966
Entity
Organization
Contact information
Practice address
4550 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3518
(333) 766-7966
(877) 840-4367
Mailing address
137 N HIDDENBROOKE DR, ADVANCE, NC 27006-7299
(336) 766-7966
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07350
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992888242
—
NC
Enumeration date
10/30/2017
Last updated
08/14/2023
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