Donnelly, Kristine

Donnelly, Kristine is an individual health care provider with primary practice located at 2510 S Texas Ave , Bryan TX 77802-2329. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Donnelly, Kristine can be contacted via phone (979) 704-5245.

Contact Information

Primary practice address
2510 S Texas Ave Bryan TX 77802-2329
Phone: (979) 704-5245
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 25239 Texas

Profile Details

NPI number 1104016344
LBN Legal business name Donnelly, Kristine
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2007
Last updated Sep 26th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104016344 NPPES
Texas MEDICAID 209944216
Texas MEDICAID 379870403

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