DR. Benjamin Kellum, DDS

NPI #1225481930 in Pocatello, Idaho

Provider Information

NPI Number: 1225481930
Entity Type: Individual
Name: DR. Benjamin Kellum, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 18, 2016
Last Updated: Jul 18, 2016

Practice Location

Address: IDAHO STATE UNIVERSITY
City: Pocatello
State: Idaho
ZIP Code: 83209-0001
Phone: (208) 282-3289

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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