| Donald C. Kellner Dds-aurora Pc | |
|
143 South Lincoln Ave Suite A Aurora IL 60505 | |
| (630) 859-3151 | |
| (630) 851-0105 |
| Full Name | Donald C. Kellner Dds-aurora Pc |
|---|---|
| Speciality | Dentist |
| Location | 143 South Lincoln Ave, Aurora, Illinois |
| Authorized Official Name and Position | Donald C. Kellner (OWNER/DENTIST) |
| Authorized Official Contact | 6308593151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald C. Kellner Dds-aurora Pc 143 South Lincoln Ave Suite A Aurora IL 60505 Ph: (630) 859-3151 | Donald C. Kellner Dds-aurora Pc 143 South Lincoln Ave Suite A Aurora IL 60505 Ph: (630) 859-3151 |
| NPI Number | 1972878197 |
|---|---|
| Provider Enumeration Date | 03/21/2012 |
| Last Update Date | 03/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972878197 | NPI | - | NPPES |
| 019017632 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019017632 (Illinois) | Primary |
| 122300000X | Dentist | 019028094 (Illinois) | Secondary |
| 122300000X | Dentist | 019024905 (Illinois) | Secondary |
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