Provider Demographics
NPI:1083954036
Name:DEWINDT, KEITH ADAMS (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ADAMS
Last Name:DEWINDT
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 1:2700 P G A BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2958
Mailing Address - Country:US
Mailing Address - Phone:561-622-6100
Mailing Address - Fax:561-622-6107
Practice Address - Street 1:2700 P G A BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2958
Practice Address - Country:US
Practice Address - Phone:561-622-6100
Practice Address - Fax:561-622-6107
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8411122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist