Provider Demographics
NPI:1104089549
Name:HARLING, KEL-LEE STAR (DDS)
Entity type:Individual
Prefix:
First Name:KEL-LEE
Middle Name:STAR
Last Name:HARLING
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KEL-LEE
Other - Middle Name:STAR
Other - Last Name:HAMMEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21301 E RUSSET RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-5496
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4374 E BUTTE AVE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AZ
Practice Address - Zip Code:85132
Practice Address - Country:US
Practice Address - Phone:520-868-0201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD008157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist