DEREK R. KAELIN D.D.S LLC NPI 1295030203

NPI Information

DEREK R. KAELIN, D.D.S, LLC is a dental clinic center in Springfield, MO. DEREK R. KAELIN, D.D.S, LLC NPI is 1295030203. The provider is registered as an organization entity type.
The provider Is Doing Business As Northside Dental Clinic.

The provider's business location address is:

2105 W KEARNEY ST STE A
SPRINGFIELD, MO
ZIP 65803-666
Phone: (417) 862-2468
Fax: (417) 863-6775

The provider's authorized official is Derek R Kaelin .
The authorized official title is Dentist / Owner and has the following contact phone number (417) 862-2468.

The enumeration date for this NPI number is 1/21/2011 and was last updated on 1/21/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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