Provider Demographics
NPI:1245467075
Name:KELLY, EMILY SCHMALZ (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SCHMALZ
Last Name:KELLY
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3142 WELLNER DR NE
Mailing Address - Street 2:IMPLANT AND PERIODONTAL PROFESSIONALS
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-8388
Mailing Address - Country:US
Mailing Address - Phone:507-206-6452
Mailing Address - Fax:
Practice Address - Street 1:3142 WELLNER DR NE
Practice Address - Street 2:IMPLANT AND PERIODONTAL PROFESSIONALS
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-8388
Practice Address - Country:US
Practice Address - Phone:507-206-6452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND127731223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics