Individual
MARY KELLSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9543
(360) 330-9860
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9543
(360) 330-9860
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00005629
WA
Other
Enumeration date
12/19/2016
Last updated
12/19/2016
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