Individual
DR. PATRICK DALE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
608 HWY 12 WEST, BOWMAN, ND 58623-0710
(701) 523-3255
(701) 523-5742
Mailing address
608 HWY 12 WEST, BOX 710, BOWMAN, ND 58623-0710
(701) 523-3255
(701) 523-5742
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1746
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40965
—
ND
Enumeration date
01/19/2007
Last updated
07/08/2007
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