Provider Demographics
NPI:1336297977
Name:SYLVESTER, DAVID KEITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KEITH
Last Name:SYLVESTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:KEITH
Other - Middle Name:
Other - Last Name:SYLVESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2014 GUS KAPLAN DRIVE
Mailing Address - Street 2:DR KEITH SYLVESTER
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301
Mailing Address - Country:US
Mailing Address - Phone:318-443-7080
Mailing Address - Fax:318-443-7793
Practice Address - Street 1:2014 GUS KAPLAN DRIVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-443-7080
Practice Address - Fax:318-443-7793
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA43171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice