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1164928560
KELLY ELIZABETH FENNELLY
SYRACUSE, NY
NPI
1164928560
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2018-04-04
Last Update Date
2018-04-04
Business Address
KELLY ELIZABETH FENNELLY DMD
750 E ADAMS ST
SYRACUSE, NY 13210-2306
Phone number: 315-464-4148
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Mailing Address
KELLY ELIZABETH FENNELLY DMD
253 BOULEVARD
POMPTON PLAINS, NJ 07444-1707
Phone number: 973-747-2645
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