Provider Demographics
NPI:1871647826
Name:KELLY & ZEFFERY, D.D.S., LTD.
Entity Type:Organization
Organization Name:KELLY & ZEFFERY, D.D.S., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:ZEFFERY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-566-5100
Mailing Address - Street 1:444 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1963
Mailing Address - Country:US
Mailing Address - Phone:847-566-5100
Mailing Address - Fax:847-566-5160
Practice Address - Street 1:444 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1963
Practice Address - Country:US
Practice Address - Phone:847-566-5100
Practice Address - Fax:847-566-5160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental