Provider Demographics
NPI:1366487779
Name:BINZ, KEITHLEY ELIZABETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITHLEY
Middle Name:ELIZABETH
Last Name:BINZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9047 VERANDA CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-2608
Mailing Address - Country:US
Mailing Address - Phone:210-681-7430
Mailing Address - Fax:
Practice Address - Street 1:1406 FITCH ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-1406
Practice Address - Country:US
Practice Address - Phone:210-922-6922
Practice Address - Fax:210-921-1313
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX179211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice