| NPI | 1558772723 |
|---|---|
| Doing Business As | GWENDOLYN KELLY DDS |
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN A KELLY Owner 310-412-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 29936) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CA 45472) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CA 20070) | |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-09 |