Soares, Kelly

Soares, Kelly is an individual health care provider with primary practice located at 30 Saint James Ave , Chicopee MA 01020-2453. She recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is her primary health care specialty. Soares, Kelly can be contacted via phone (413) 592-2177.

Contact Information

Primary practice address
30 Saint James Ave Chicopee MA 01020-2453
Phone: (413) 592-2177
Fax: (413) 592-3278
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 19743 Massachusetts
Dental Providers / General Practice 1223G0001X DN1857981 Massachusetts
Dental Providers / Dentist 122300000X DN19743 Massachusetts

Profile Details

NPI number 1780645002
LBN Legal business name Soares, Kelly
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Sep 10th, 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 1780645002 NPPES
Massachusetts MEDICAID 1301071

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