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NPI Code Detail

MEDICARE: DR. DAVID MICHAEL MCKELLAR DDS

MEDICARE:  DR. DAVID MICHAEL MCKELLAR  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist138677-9922UT

General Provider Information

NPI Number : 1881755171
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID MICHAEL MCKELLAR DDS
Provider Business Mailing Address
First Line : 3984 WASHINGTON BLVD
Second Line :
City : OGDEN
State : UT
Zip : 84403-1826
Country : US
Telephone Number : 801-399-4477
Fax Number : 801-399-4478
Provider Business Practice Location Address
First Line : 3984 WASHINGTON BLVD
Second Line :
City : OGDEN
State : UT
Zip : 84403-1826
Country : US
Telephone Number : 801-399-4477
Fax Number : 801-399-4478
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 07/08/2007

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Directions to “ DR. DAVID MICHAEL MCKELLAR DDS” Practice Location

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