Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK KELLY, DMD
Active Sole ProprietorJACK KELLY, DMD is a Student (Health Education/Training) healthcare provider located in WACO, Texas. NPI 1679032452 is currently active in the NPPES registry. Verify at CMS.
Student (Health Education/Training) · WACO, TX
Registration Details
- NPI Number
- 1679032452
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 19, 2019 (7.2213496683159 yrs)
- Last Updated
- Mar 19, 2019
- Sole Proprietor
- Yes
Practice Information
- Address
-
609 ELM STWACO, TX, 767042516Browse TX providers · Browse ZIP 76704
- Phone
- 2543136960
- Primary Specialty
-
Student (Health Education/Training)
390200000X
Other Student (Health Education/Training) Providers in WACO, TX
| Name | Credential | NPI |
|---|---|---|
| DAWNA CAMPBELL | M. A. | 1508281429 |
| PAN CHANG | DDS | 1407214844 |
| WHITLEY BROOK SEPULVEDA | — | 1790202414 |
| ASA FENTON HOOVER | — | 1023608346 |
| CHRISTINA DANIELLE LANDRUM | — | 1316537152 |
| JADE ALYSSE HOLLOWAY | — | 1417623216 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.