| NPI | 1932485380 |
|---|---|
| Other Name | KELLAM ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | STEPHEN A KELLAM President/Owner 505-982-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NM 1798) |
| Enumeration Date | 2011-10-31 |
| Last Update Date | 2011-10-31 |