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Individual

DR. MICHAEL DAVID KELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
19643 BLUE BIRD LN, REHOBOTH BEACH, DE 19971-6129
(302) 226-7960
Mailing address
15254 ROBINSON DR, MILTON, DE 19968-3784
(302) 542-6337

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
G1-0001318
DE
390200000X
Student in an Organized Health Care Education/Training Program
G3-0000382
DE

Other

Enumeration date
05/18/2011
Last updated
06/17/2013
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