Organization
DEREK R. KAELIN D.D.S, LLC
Active
Other names
James River Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK R KAELIN DDS (DENTIST OWNER)
(417) 862-2468
Entity
Organization
Contact information
Practice address
4205 S NATURE CENTER WAY, SPRINGFIELD, MO 65804-4921
(417) 862-2468
Mailing address
4205 S NATURE CENTER WAY, SPRINGFIELD, MO 65804-4921
(417) 862-2468
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2003017125
MO
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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