Provider Demographics
NPI:1871669895
Name:KELSEY, WILLIAM PATRICK III (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PATRICK
Last Name:KELSEY
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:220 N 89TH ST
Mailing Address - Street 2:STE 203
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4072
Mailing Address - Country:US
Mailing Address - Phone:402-390-6006
Mailing Address - Fax:402-390-6446
Practice Address - Street 1:2141 SOUTH 63RD STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106
Practice Address - Country:US
Practice Address - Phone:402-551-1811
Practice Address - Fax:402-280-5093
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE4486122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE36495OtherUNITED CONCORDIA
NE05157OtherBLUE CROSS BLUE SHIELD