Provider Demographics
NPI:1265518922
Name:KELLAR, ARNOLD L (DDS)
Entity type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:L
Last Name:KELLAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 BALTIMORE BLVD
Mailing Address - Street 2:#412
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-876-1747
Mailing Address - Fax:410-876-1927
Practice Address - Street 1:532 BALTIMORE BLVD
Practice Address - Street 2:#412
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157
Practice Address - Country:US
Practice Address - Phone:410-876-1747
Practice Address - Fax:410-876-1927
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD102421223G0001X
MDMD10242122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice