NPI 1063764579

Kelly Family Dentistry

Organisation Dentist Grand Island, NE

Practice location

Address: 2412 W Faidley Ave, Grand Island, NE 68803-4327
Phone: (308) 389-2811
Fax: (308) 389-2871

Authorised official

Name: Brad James Kelly
Title: Owner/Dentist
Phone: (308) 389-2811

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X

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Registry record

NPI: 1063764579
Entity type: Organization
NPI issued: 8 Oct 2012
Record last updated: 8 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.