Individual
JOHN DAVID KELLER IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4920 HONONEGAH RD, ROSCOE, IL 61073-7778
(815) 623-3926
(815) 623-3930
Mailing address
4920 HONONEGAH RD, ROSCOE, IL 61073-7778
(815) 623-3926
(815) 623-3930
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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