Kelly, Lisa D

Kelly, Lisa D is an individual health care provider with primary practice located at 4072 Victory Blvd , Portsmouth VA 23701-2820. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Kelly, Lisa D can be contacted via phone (757) 465-3834.

Contact Information

Primary practice address
4072 Victory Blvd Portsmouth VA 23701-2820
Phone: (757) 465-3834
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0401008564 Virginia

Profile Details

NPI number 1245202670
LBN Legal business name Kelly, Lisa D
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2006
Last updated Dec 4th, 2019 - about 5 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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