Organization
DONALD C. KELLNER DDS-WOOD DALE PC
Active
Parent organization
DONALD C. KELLNER DDS-WOOD DALE PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DONALD C. KELLNER DDS-WOOD DALE PC
Authorized official
DR. DONALD C. KELLNER DDS (OWNER/DENTIST)
(630) 860-9100
Entity
Organization
Contact information
Practice address
333 NORTH WOOD DALE RD, SUITE A, WOOD DALE, IL 60191
(630) 860-9100
(630) 787-0662
Mailing address
333 NORTH WOOD DALE RD, SUITE A, WOOD DALE, IL 60191
(630) 860-9100
(630) 787-0662
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019017632
IL
122300000X
Dentist
019024905
IL
122300000X
Dentist
019026111
IL
122300000X
Dentist
019028094
IL
122300000X
Dentist
021001200
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019017632
—
IL
Enumeration date
03/26/2012
Last updated
03/26/2012
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