Organization
DESTIN DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY PAUL KELLUM D.D.S. (OWNER)
(850) 837-6645
Entity
Organization
Contact information
Practice address
985 AIRPORT ROAD, DESTIN, FL 32541-2835
(850) 837-6645
(850) 650-8553
Mailing address
985 AIRPORT ROAD, DESTIN, FL 32541-2835
(850) 837-6645
(850) 650-8553
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/09/2020
Last updated
03/09/2020
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