BENJAMIN KELLUM

POCATELLO, ID
NPI1225481930
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: ID  d4772)
Enumeration Date2016-07-18
Last Update Date2016-07-18
Business Address
Dr. BENJAMIN KELLUM DDS
IDAHO STATE UNIVERSITY
POCATELLO, ID 83209-0001
Phone number: 208-282-3289
Mailing Address
Dr. BENJAMIN KELLUM DDS
IDAHO STATE UNIVERSITY
POCATELLO, ID 83209-0001
Phone number:
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