Kelly, Samantha Jo
Kelly, Samantha Jo is an sole proprietor health care provider with primary practice located at 1710 Nashville Pike # 102 , Gallatin TN 37066. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Kelly, Samantha Jo can be contacted via phone (615) 461-7491.Contact Information
Primary practice address
1710 Nashville Pike # 102
Gallatin TN 37066
Phone: (615) 461-7491
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | LDR170183 | Indiana |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 10949 | Tennessee |
Profile Details
| NPI number | 1255852661 |
|---|---|
| LBN Legal business name | Kelly, Samantha Jo |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 6th, 2017 |
| Last updated | Jul 25th, 2019 - about 7 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.
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