Most Relevant Information
Provider Data
| NPI Number: | 1003416017 |
| Provider Name: | PHILLIP JEFFERY KELEMEN DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | DN9377 |
Most Important Dates
| Enumeration Date: | 10/28/2020 |
| Last Updated: | 10/28/2020 |
Provider Practice Location
5913 PLAINVIEW DR
PORT ORANGE
FL
321278911
Practice Location Phone/Fax
| Phone: | 3868823139 |
| Fax: |
Provider Mailing Location
5913 PLAINVIEW DR
PORT ORANGE
FL
321278911
Provider Mailing Phone/Fax
| Phone: | 3868823139 |
| Fax: |