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Dr. Diane Collette Kelly, DMD
Pediatric Dentist in Dacula, Georgia
NPI 1851431522

Diane Collette Kelly is a Pediatric Dentist based in Dacula, GA and is specialized in Pediatric Dentistry. Diane Collette Kelly practices in Dacula, GA and has the professional credentials of DMD. The NPI Number for Diane Collette Kelly is 1851431522 and holds a License No. DN012082 (Georgia).

The current practice location address for Diane Collette Kelly is 2119 Hamilton Creek Pkwy, Dacula, GA and can be reached out via phone at 678-714-7011 and via fax at 678-714-8388.

Location: 2119 Hamilton Creek Pkwy, Dacula, GA, 30019-3293
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1851431522
Provider Name
Diane Collette Kelly
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
2119 Hamilton Creek Pkwy, Dacula, GA, 30019-3293
Phone Number
678-714-7011
Fax Number
678-714-8388
Provider Enumeration Date
02/08/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
DN012082 01 GA DENTAL LICENSE NUMBER
institution
Provider Business Practice Location Address Details
Address
2119 Hamilton Creek Pkwy
City
Dacula
State
Georgia
Zip
30019-3293
Phone Number
678-714-7011
Fax Number
678-714-8388
person
Provider Business Mailing Address Details
Address
2119 Hamilton Creek Pkwy
City
Dacula
State
Georgia
Zip
30019-3293
Phone Number
678-714-7011
Fax Number
678-714-8388
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DN012082 (Georgia)
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.
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