Ettelbrick, Kelli L
Ettelbrick, Kelli L is an individual health care provider with primary practice located at 8380 Warren Pkwy Suite 400, Frisco TX 75034-4198. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Ettelbrick, Kelli L can be contacted via phone (214) 387-0099.Contact Information
Primary practice address
8380 Warren Pkwy Suite 400
Frisco TX 75034-4198
Phone: (214) 387-0099
Fax: (214) 387-0104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 19146 | Texas |
Profile Details
| NPI number | 1578505038 |
|---|---|
| LBN Legal business name | Ettelbrick, Kelli L |
| Credentials | D.D.S., M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2006 |
| Last updated | Jul 27th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578505038 | NPPES |
| Texas | MEDICAID | 090844401 |
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