Individual
DR. STEPHEN A KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
539 HARKLE RD, SUITE D, SANTA FE, NM 87505-4782
(505) 982-5531
Mailing address
539 HARKLE RD, SUITE D, SANTA FE, NM 87505-4782
(505) 982-5531
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DD-1798
NM
Other
Enumeration date
02/08/2007
Last updated
10/31/2011
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