Destin Dental Care LLC

NPI #1821623901 in Destin, Florida

Provider Information

NPI Number: 1821623901
Entity Type: Organization
Organization Name: Destin Dental Care LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Mar 9, 2020
Last Updated: Mar 9, 2020

Practice Location

Address: 985 AIRPORT ROAD
City: Destin
State: Florida
ZIP Code: 32541-2835
Phone: (850) 837-6645

Authorized Official

Name: HENRY PAUL KELLUM, D.D.S.
Title: OWNER
Phone: (850) 837-6645

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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