| NPI | 1366008971 |
|---|---|
| Doing Business As | KELLY LANE DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | YUNYI DING Operating Member 210-995-4492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |