Provider Demographics
NPI:1972882132
Name:PRETTYMAN, KELLY CAITLYN (DDS)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:CAITLYN
Last Name:PRETTYMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 MIAL ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608-1817
Mailing Address - Country:US
Mailing Address - Phone:919-332-2120
Mailing Address - Fax:
Practice Address - Street 1:6837 FALLS OF NEUSE RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5308
Practice Address - Country:US
Practice Address - Phone:919-847-1322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist