Provider Demographics
NPI:1073517348
Name:KEEHN, DON R (DDS)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:R
Last Name:KEEHN
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 1:8191 BROADVIEW RD
Mailing Address - Street 2:STE 102
Mailing Address - City:BROADVIEW HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-1661
Mailing Address - Country:US
Mailing Address - Phone:440-526-7369
Mailing Address - Fax:440-526-7369
Practice Address - Street 1:8191 BROADVIEW RD
Practice Address - Street 2:STE 102
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1661
Practice Address - Country:US
Practice Address - Phone:440-526-7369
Practice Address - Fax:440-526-7369
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-43021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice