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NPI Code Detail

MEDICARE: DR. DAVID ARLINGTON KELLER SR. DDS

MEDICARE: DR. DAVID ARLINGTON KELLER SR. 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
1122300000XDentistDE00011209WA

General Provider Information

NPI Number : 1386647949
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID ARLINGTON KELLER SR. DDS
Provider Business Mailing Address
First Line : 215 NW 78TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-7972
Country : US
Telephone Number : 360-693-2577
Fax Number :
Provider Business Practice Location Address
First Line : 215 NW 78TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98665-7972
Country : US
Telephone Number : 360-693-2577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2005
Last Update Date : 04/03/2012

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