Provider Demographics
NPI:1073723524
Name:KEEFER, JOSEPH L (DMD,MAGD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:KEEFER
Suffix:
Gender:M
Credentials:DMD,MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 848
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-0848
Mailing Address - Country:US
Mailing Address - Phone:704-263-3770
Mailing Address - Fax:704-263-3778
Practice Address - Street 1:400 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:STANLEY
Practice Address - State:NC
Practice Address - Zip Code:28164-2055
Practice Address - Country:US
Practice Address - Phone:704-263-3770
Practice Address - Fax:704-263-3778
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice