Provider Demographics
NPI:1720445331
Name:KELES, AHMED (DDS)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:KELES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02142-1200
Mailing Address - Country:US
Mailing Address - Phone:617-892-8245
Mailing Address - Fax:
Practice Address - Street 1:245 FIRST ST CAMBRIDGE
Practice Address - Street 2:17TH FLOOR
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142
Practice Address - Country:US
Practice Address - Phone:617-892-8245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA127931223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics