W. David Kelly, Dmd
LBN: Crompton Park Oral Surgery And Implant Associates, Llc
W. David Kelly, Dmd is an health care organization with primary practice located at 59 Quinsigamond Ave , Worcester MA 01610-1867. The organization recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as the primary health care specialty.
Crompton Park Oral Surgery And Implant Associates, Llc can be contacted via phone (508) 799-2550, or through Kelly, W David via phone (508) 799-2550.
Contact Information
Primary practice address
59 Quinsigamond Ave
Worcester MA 01610-1867
Phone: (508) 799-2550
Fax: (508) 756-2923
Website:
Authorized official contact:
Name: Kelly, W David Doctor of Dental Medicine (DMD)
Phone: (508) 799-2550
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 12222 | Massachusetts |
Profile Details
| NPI number | 1033434659 |
|---|---|
| LBN Legal business name | Crompton Park Oral Surgery And Implant Associates, Llc |
| DBA Doing business as | W. David Kelly, Dmd |
| Authorized official | Kelly, W David Doctor of Dental Medicine (DMD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 7th, 2010 |
| Last updated | Jun 11th, 2010 - about 14 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033434659 | NPPES |
| Massachusetts | MEDICAID | 110009711A |
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