# KELNER PERIODONTICS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396096855
- **Authorized official:** DANIELLE B. KELNER D.M.D (OWNER)
- **Authorized official phone:** (732) 382-9090

## Contact information

- **Practice address:** 1119 RARITAN RD, CLARK, NJ 07066
- **Practice address phone:** (908) 753-4427
- **Practice address fax:** (908) 756-7019
- **Mailing address:** 1119 RARITAN RD, CLARK, NJ 07066
- **Mailing address phone:** (732) 382-9090
- **Mailing address fax:** (732) 396-1527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22D102321200 | NJ | Yes |

## Other

- **Enumeration date:** 09/25/2012
- **Last updated:** 09/25/2012