Mcdermott, Kelly Hartnett
Mcdermott, Kelly Hartnett is an sole proprietor health care provider with primary practice located at 111 Gaslight Blvd Suite A, Lufkin TX 75904-3188. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Mcdermott, Kelly Hartnett can be contacted via phone (936) 634-8201.Contact Information
Primary practice address
111 Gaslight Blvd Suite A
Lufkin TX 75904-3188
Phone: (936) 634-8201
Fax: (936) 639-2187
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 22144 | Texas |
Profile Details
| NPI number | 1124183330 |
|---|---|
| LBN Legal business name | Mcdermott, Kelly Hartnett |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Sep 22nd, 2010 - about 14 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 | 1124183330 | NPPES |
| Texas | MEDICAID | 175004401 |
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