Kelley, Gene Samuel

Kelley, Gene Samuel is an sole proprietor health care provider with primary practice located at 126 Main St N , Stillwater MN 55082-5020. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kelley, Gene Samuel can be contacted via phone (651) 439-3637.

Contact Information

Primary practice address
126 Main St N Stillwater MN 55082-5020
Phone: (651) 439-3637
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D6873 Minnesota

Profile Details

NPI number 1871625780
LBN Legal business name Kelley, Gene Samuel
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2007
Last updated Jul 8th, 2007 - about 18 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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