Organization
DR. STEPHEN A. KELLAM, LLC
Active
Other names
Kellam Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN A KELLAM D.M.D., M.S. (PRESIDENT/OWNER)
(505) 982-5531
Entity
Organization
Contact information
Practice address
539 HARKLE RD STE D, SANTA FE, NM 87505-4783
(505) 982-5531
Mailing address
539 HARKLE RD STE D, SANTA FE, NM 87505-4783
(505) 982-5531
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1798
NM
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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