Individual
REBECCA MOOAR KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
573 HOPMEADOW ST, SIMSBURY, CT 06070-2462
(860) 658-0010
Mailing address
573 HOPMEADOW ST, SIMSBURY, CT 06070-2462
(860) 658-0010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11201
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2014
Last updated
12/10/2018
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