Kelly, Terence Patrick

Kelly, Terence Patrick is an individual health care provider with primary practice located at 500 Gypsy Ln , Youngstown OH 44504. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Kelly, Terence Patrick can be contacted via phone (330) 884-1000.

Contact Information

Primary practice address
500 Gypsy Ln Youngstown OH 44504
Phone: (330) 884-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 30-017132 Ohio
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 57.246804 Ohio

Profile Details

NPI number 1508927757
LBN Legal business name Kelly, Terence Patrick
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated Jun 29th, 2018 - about 7 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 1508927757 NPPES
Ohio MEDICAID 2073232

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