Individual
DR. DOUGLAS ALAN KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2733 HORSE PEN CREEK RD, SUITE 107, GREENSBORO, NC 27410-8399
(336) 854-9270
(336) 854-5628
Mailing address
2733 HORSE PEN CREEK RD, SUITE 107, GREENSBORO, NC 27410-8399
(336) 854-9270
(336) 854-5628
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5307
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5307
DENTAL LICENSE
NC
Enumeration date
02/19/2007
Last updated
07/08/2007
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