Kellerman Dental

NPI #1215102579 in Glen Carbon, Illinois

Provider Information

NPI Number: 1215102579
Entity Type: Organization
Organization Name: Kellerman Dental
Primary Specialty: Dentist
Enumeration Date: Apr 28, 2008
Last Updated: Apr 28, 2008

Practice Location

Address: 16 JUNCTION DR W STE 101
City: Glen Carbon
State: Illinois
ZIP Code: 62034-2996
Phone: (618) 288-3535

Authorized Official

Name: KEVIN J KELLERMAN
Title: DOCTOR
Phone: (618) 288-3535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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