JACK KELLY, DMD

Student in an Organized Health Care Education/Training Program

Active Individual
NPI: 1679032452

Practice Address

609 ELM ST
Waco, TX 76704

Phone: (254) 313-6960

Specialties

Specialty Code Primary License
Student in an Organized Health Care Education/Training Program 390200000X Yes -

Frequently Asked Questions

NPI 1679032452 is the National Provider Identifier for JACK KELLY, DMD, a Student in an Organized Health Care Education/Training Program provider located in Waco, TX. This NPI was enumerated on March 19, 2019.
JACK KELLY, DMD practices at 609 ELM ST, Waco, TX 76704.

Quick Facts

NPI
1679032452
Type
Individual
Enumerated
Mar 19, 2019
Last Updated
Mar 19, 2019

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