| NPI | 1972347631 | 
|---|---|
| Former Name | REILLY GRAY KELLEY | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 122300000X Dentist (Licence: SC DGD.10847)  | 
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC DGD.10847)  | 
| Enumeration Date | 2024-06-19 | 
| Last Update Date | 2025-07-09 |