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NPI Code Detail

MEDICARE: DR. KATE W KELLY DDS

MEDICARE: DR. KATE W KELLY DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist30-022338OH

General Provider Information

NPI Number : 1346342797
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATE W KELLY DDS
Provider Business Mailing Address
First Line : 2750 DOVER CENTER RD
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-4501
Country : US
Telephone Number : 440-835-7272
Fax Number : 440-835-7269
Provider Business Practice Location Address
First Line : 2750 DOVER CENTER RD
Second Line :
City : WESTLAKE
State : OH
Zip : 44145-4501
Country : US
Telephone Number : 440-835-7272
Fax Number : 440-835-7269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2006
Last Update Date : 07/08/2007

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