Organization
DR. K'S PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN ANTHONY KELLEHER DDS (OWNER)
(209) 242-3439
Entity
Organization
Contact information
Practice address
1050 S COBB ST UNIT A, PALMER, AK 99645-6916
(209) 242-3439
Mailing address
1050 S COBB ST UNIT A, PALMER, AK 99645-6916
(209) 242-3439
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1578
AK
Other
Enumeration date
02/12/2016
Last updated
02/12/2016
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