Organization
DR K'S PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN A KELLEHER DDS (OWNER)
(209) 242-3439
Entity
Organization
Contact information
Practice address
125 W EVERGREEN AVE, #204, PALMER, AK 99645-6950
(209) 242-3439
Mailing address
1050 S COBB ST, UNIT A, PALMER, AK 99645-6916
(209) 602-0686
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1578
AK
Other
Enumeration date
12/18/2015
Last updated
12/18/2015
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