Keltner, Corwin Jay

Keltner, Corwin Jay is an individual health care provider with primary practice located at 5974 Fashion Point Dr Ste 210 , Ogden UT 84403-4842. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Keltner, Corwin Jay can be contacted via phone (801) 475-6121.

Contact Information

Primary practice address
5974 Fashion Point Dr Ste 210 Ogden UT 84403-4842
Phone: (801) 475-6121
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 60068 Kansas
Dental Providers / Dentist 122300000X 323334-9922 Utah

Profile Details

NPI number 1083604599
LBN Legal business name Keltner, Corwin Jay
Credentials DDS, PPA
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Dec 11th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1083604599 NPPES
Kansas Other 116645 BLUE CROSS BLUE SHIELD ID
Kansas MEDICAID 100392360B BLUE CROSS BLUE SHIELD ID

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