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Samantha Jo Kelly
Pediatric Dentist in Gallatin, Tennessee
NPI 1255852661

Samantha Jo Kelly is a Pediatric Dentist based in Gallatin, TN and is specialized in Pediatric Dentistry. Samantha Jo Kelly practices in Gallatin, TN. The NPI Number for Samantha Jo Kelly is 1255852661 and holds a License No. LDR170183 (Tennessee).

The current practice location address for Samantha Jo Kelly is 1710 Nashville Pike # 102, Gallatin, TN and can be reached out via phone at 615-461-7491.

Location: 1710 Nashville Pike # 102, Gallatin, TN, 37066-3154
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1255852661
Provider Name
Samantha Jo Kelly
Credential
Provider Entity Type
Individual
Gender
Female
Address
1710 Nashville Pike # 102, Gallatin, TN, 37066-3154
Phone Number
615-461-7491
Fax Number
Provider Enumeration Date
07/06/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1710 Nashville Pike # 102
City
Gallatin
State
Tennessee
Zip
37066
Phone Number
615-461-7491
Fax Number
person
Provider Business Mailing Address Details
Address
1710 Nashville Pike # 102
City
Gallatin
State
Tennessee
Zip
37066
Phone Number
615-461-7491
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
10949 (Tennessee)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
LDR170183 (Indiana)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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