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General NPI Number Information
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NPI Number | 1134265952
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Entity Type | Individual
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Provider Name | PATRICIA NOEL KELLAR DDS
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Gender | Female
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 02/05/2015
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Provider Practice Location Address
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Address Line | 5509 PLEASANT VALLEY DR SUITE 100
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City | PLANO
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State | TX
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Zip | 75023-5248
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Country | US
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Telephone | 972-612-9737
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Fax | 972-612-8647
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Provider Business Mailing Address
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Address Line | 5501 INDEPENDENCE PKWY SUITE 204
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City | PLANO
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State | TX
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Zip | 75023-5463
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Country | US
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Telephone | 972-612-9737
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Fax | 972-612-8647
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15572
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License Number State | TX
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