NPI: 1033434659
Provider Name: CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLC
Doing Business As: W. DAVID KELLY, DMD
Classification: Dentist - 1223S0112X
Entity Type: Organization
Specialization: Oral and Maxillofacial Surgery
Address:
59 QUINSIGAMOND AVE
WORCESTER, MA
ZIP 01610
Phone: (508) 799-2550
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CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLC is an oral and maxillofacial surgery dentist in Worcester, MA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. CROMPTON PARK ORAL SURGERY AND IMPLANT ASSOCIATES, LLC NPI is 1033434659. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As W. David Kelly, Dmd.
The provider's business location address is:
59 QUINSIGAMOND AVE
WORCESTER, MA
ZIP 01610-867
Phone: (508) 799-2550
Fax: (508) 756-2923
The provider's authorized official is W David Kelly .
The authorized official title is Sole Member and has the following contact phone number (508) 799-2550.
The enumeration date for this NPI number is 4/7/2010 and was last updated on 6/11/2010.