Individual
ELIJAH KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1213 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6319
(269) 870-5105
Mailing address
1213 E COOLSPRING AVE, MICHIGAN CITY, IN 46360-6319
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12014755A
IN
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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