Provider Demographics
NPI:1194540203
Name:KELSEY A HARNEY DMD LLC
Entity type:Organization
Organization Name:KELSEY A HARNEY DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KELSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-797-3130
Mailing Address - Street 1:2 BLACKSTRAP RD
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-2238
Mailing Address - Country:US
Mailing Address - Phone:207-797-3130
Mailing Address - Fax:
Practice Address - Street 1:2 BLACKSTRAP RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2238
Practice Address - Country:US
Practice Address - Phone:207-797-3130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental