Individual
DANIEL H. KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
505 ROBINS ST, TUPELO, MS 38804-3715
(662) 842-5080
(662) 842-5896
Mailing address
PO BOX 1486, TUPELO, MS 38802-1486
(662) 842-5080
(662) 842-5896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1782-77
MS
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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