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Contact Information

TIMOTHY M. KELLY, DMD, PA
1441 CARLISLE BLVD NE
SUITE D
ALBUQUERQUE, NM87110-5610
 Phone: 505-256-1770
 Fax: 505-255-0220
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dental Public Health

1223D0001X
 

Customized Equipment

332BC3200X 87 All Other Suppliers
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for TIMOTHY M KELLY DMD PA · (Female)

NPI # 1558736991
Status Active
Credentials
Entity Individual
Enumeration date 12/10/2015
Last updated 02/19/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • NM License # 1413
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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