Individual
DR. TRENT MERRILL KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1991 W BROADWAY ST, IDAHO FALLS, ID 83402-3041
(208) 999-4746
Mailing address
1991 W BROADWAY ST, IDAHO FALLS, ID 83402-3041
(208) 999-4746
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30023683
OH
Other
Enumeration date
06/11/2012
Last updated
11/29/2023
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