Provider Demographics
NPI:1295974376
Name:ENGLISH, KELLY ALLYSON (RDH)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ALLYSON
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-5426
Mailing Address - Country:US
Mailing Address - Phone:682-223-1331
Mailing Address - Fax:
Practice Address - Street 1:6050 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2294
Practice Address - Country:US
Practice Address - Phone:972-316-6320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13033124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist