Provider Demographics
NPI:1083799464
Name:MCKEEVER, KEVIN J (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:MCKEEVER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 GREEN POND RD
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-4209
Mailing Address - Country:US
Mailing Address - Phone:973-983-9006
Mailing Address - Fax:
Practice Address - Street 1:474 GREEN POND RD
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-4209
Practice Address - Country:US
Practice Address - Phone:973-983-9006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ139541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice