Individual
DR. ANDREW WAYNE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5509B W FRIENDLY AVE STE 200, GREENSBORO, NC 27410-4279
(336) 766-7966
(877) 840-4367
Mailing address
137 N HIDDENBROOKE DR, ADVANCE, NC 27006-7299
(336) 766-7966
(336) 940-5346
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
35919
CA
1223G0001X
General Practice Dentistry
Primary
7350
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932611092
—
NC
01
—
82-3139362
IRS
—
Enumeration date
10/23/2006
Last updated
08/14/2023
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