Individual
DR. J SKELLY KRELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1000 C M FAGAN DR, SUITE C, HAMMOND, LA 70403-6055
(985) 542-9608
(985) 542-3114
Mailing address
1000 C M FAGAN DR, SUITE C, HAMMOND, LA 70403-6055
(985) 542-9608
(985) 542-3114
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2651
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1826511
—
LA
Enumeration date
05/08/2006
Last updated
08/02/2010
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