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General NPI Number Information
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NPI Number | 1215831433
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Entity Type | Organization
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Legal Business Name | JAY KELTNER DDS, P.C.
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Dates
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Enumeration Date | 10/03/2026
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Last Update Date | 10/03/2026
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Provider Practice Location Address
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Address Line | 375 E LAGOON ST
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City | ROOSEVELT
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State | UT
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Zip | 84066-3017
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Country | US
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Telephone | 435-722-2293
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Fax | 435-722-3379
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Provider Business Mailing Address
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Address Line | 375 E LAGOON ST
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City | ROOSEVELT
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State | UT
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Zip | 84066-3017
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Country | US
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Telephone | 435-722-2293
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Fax | 435-722-3379
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Authorized Official
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Title or Position | DDS/ OWNER
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Name | CORWIN JAY KELTNER
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Credential |
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Telephone | 435-722-2293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | NULL
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