| Matthew J. Kelly, Dds, Llc | |
|
9 E Van Buren St Millstadt IL 62260-2009 | |
| (314) 249-1514 | |
| Not Available |
| Full Name | Matthew J. Kelly, Dds, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9 E Van Buren St, Millstadt, Illinois |
| Authorized Official Name and Position | Matthew Kelly (MANAGER) |
| Authorized Official Contact | 3142491514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew J. Kelly, Dds, Llc 9 E Van Buren St Millstadt IL 62260-2009 Ph: () - | Matthew J. Kelly, Dds, Llc 9 E Van Buren St Millstadt IL 62260-2009 Ph: (314) 249-1514 |
| NPI Number | 1144625773 |
|---|---|
| Provider Enumeration Date | 10/24/2014 |
| Last Update Date | 10/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144625773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019030041 (Illinois) | Primary |