KELLERMAN DENTAL GROUP PC NPI 1538543582

NPI Information

KELLERMAN DENTAL GROUP, PC is a customized equipment durable medical equipment medical supplies in Glen Carbon, IL. KELLERMAN DENTAL GROUP, PC NPI is 1538543582. The provider is registered as an organization entity type.
The provider Is Doing Business As Kellerman Cosmetic And Family Dentistry.

The provider's business location address is:

16 JUNCTION DR W STE 101
GLEN CARBON, IL
ZIP 62034-996
Phone: (618) 288-3535
Fax: (618) 288-3434

The provider's authorized official is Kevin J Kellerman .
The authorized official title is President and has the following contact phone number (618) 288-3535.

The enumeration date for this NPI number is 7/18/2015 and was last updated on 7/18/2015.

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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