Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 39424 | CA |
NPI | 1003919416 |
---|---|
Provider Name | Dr. Daniel R Keller |
First Address | Palm Springs, CA 92262 |
Second Address | Palm Springs, CA 92262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 08/07/2007 |