SAMUEL ROBERT KELLY

SALEM, OR
NPI1174018022
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  D10822)
Enumeration Date2018-06-23
Last Update Date2018-06-23
Business Address
SAMUEL ROBERT KELLY
3380 ASTORIA WAY NE
SALEM, OR 97305-1667
Phone number: 971-600-0211
Mailing Address
SAMUEL ROBERT KELLY
3380 ASTORIA WAY NE
SALEM, OR 97305-1667
Phone number: 971-600-0211