Provider Demographics
NPI:1154844322
Name:KELLER, THOMAS FRANKLIN (DDS)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANKLIN
Last Name:KELLER
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:P.O. BOX 507
Mailing Address - Street 2:
Mailing Address - City:OWENSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45160
Mailing Address - Country:US
Mailing Address - Phone:513-375-4336
Mailing Address - Fax:
Practice Address - Street 1:8340 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-3916
Practice Address - Country:US
Practice Address - Phone:513-401-7536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300171001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice