Individual
JOSEPH THOMAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1480 W ASHLEY RD, BOONVILLE, MO 65233-2141
(660) 882-7522
(660) 882-9022
Mailing address
1480 W ASHLEY RD, BOONVILLE, MO 65233-2141
(660) 882-7522
(660) 882-9022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014008013
MO
122300000X
Dentist
8345
SC
Other
Enumeration date
03/27/2014
Last updated
07/15/2014
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