Kellerman Dental

LBN: Kellerman Dental
Kellerman Dental is an health care organization with primary practice located at 16 Junction Dr W Ste 101 , Glen Carbon IL 62034-2996. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Kellerman Dental can be contacted via phone (618) 288-3535, or through Kellerman, Kevin J via phone (618) 288-3535.

Contact Information

Primary practice address
16 Junction Dr W Ste 101 Glen Carbon IL 62034-2996
Phone: (618) 288-3535
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Kellerman, Kevin J
Phone: (618) 288-3535

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 1004560 Illinois

Profile Details

NPI number 1215102579
LBN Legal business name Kellerman Dental
DBA Doing business as
Authorized official Kellerman, Kevin J
Entity Organization
Organization subpart 1 No
Enumeration date Apr 28th, 2008
Last updated Apr 28th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215102579 NPPES
Illinois MEDICAID 108441

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