Organization
MARSHALL DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY C KELLY DDS (MEMBER)
(660) 886-6843
Entity
Organization
Contact information
Practice address
263 S JEFFERSON AVE, MARSHALL, MO 65340-2134
(660) 886-6843
(660) 886-7855
Mailing address
263 S JEFFERSON AVE, MARSHALL, MO 65340-2134
(660) 886-6843
(660) 886-7855
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
12712
MO
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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