Individual
DR. KIM BENSON KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
607 2ND ST S, NAMPA, ID 83651-3837
(208) 466-2456
(208) 318-0227
Mailing address
607 2ND ST S, NAMPA, ID 83651-3837
(208) 466-2456
(208) 318-0227
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3065
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001422900
—
ID
01
—
519891
UNITED CONCORDIA ID NUMBE
ID
01
—
60852
BLUE CROSS OF IDAHO
ID
Enumeration date
08/11/2006
Last updated
02/24/2022
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