Provider Demographics
NPI:1376992719
Name:KEY, XENIA
Entity Type:Individual
Prefix:MS
First Name:XENIA
Middle Name:
Last Name:KEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2230 CAMILLE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31906-1002
Mailing Address - Country:US
Mailing Address - Phone:706-984-2150
Mailing Address - Fax:
Practice Address - Street 1:7770 SIGHTSEEING ROAD
Practice Address - Street 2:BERNHEIM DENTAL CLINIC
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:706-545-2901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant