Provider Demographics
NPI:1306404587
Name:KEEFER, EMILY ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:ELIZABETH
Last Name:KEEFER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:ELIZABETH
Other - Last Name:SMAJDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5195 MISTY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-7111
Mailing Address - Country:US
Mailing Address - Phone:517-240-9057
Mailing Address - Fax:
Practice Address - Street 1:200 TURWILL LN STE 1
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4277
Practice Address - Country:US
Practice Address - Phone:269-344-9006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901023162122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist