Kelly, Kathleen A
Kelly, Kathleen A is an individual health care provider with primary practice located at 44 E Mifflin St Ste 204, Madison WI 53703-2895. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Kelly, Kathleen A can be contacted via phone (608) 256-0499.Contact Information
Primary practice address
44 E Mifflin St Ste 204
Madison WI 53703-2895
Phone: (608) 256-0499
Fax: (608) 256-0577
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5001920-015 | Wisconsin |
Profile Details
| NPI number | 1467455147 |
|---|---|
| LBN Legal business name | Kelly, Kathleen A |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467455147 | NPPES |
| Wisconsin | MEDICAID | 33374700 |
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