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1386853745
JERRY C. KELLY
MARSHALL, MO
NPI
1386853745
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: MO 12712)
Enumeration Date
2007-05-22
Last Update Date
2007-07-08
Business Address
Dr. JERRY C. KELLY DDS
263 S JEFFERSON AVE
MARSHALL, MO 65340-2134
Phone number: 660-886-6843
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Mailing Address
Dr. JERRY C. KELLY DDS
263 S JEFFERSON AVE
MARSHALL, MO 65340-2134
Phone number: 660-886-6843
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