Provider Demographics
NPI:1568571222
Name:GORDON D KEYES DDS INC
Entity Type:Organization
Organization Name:GORDON D KEYES DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:D
Authorized Official - Last Name:KEYES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-675-4366
Mailing Address - Street 1:751 SE BARRINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277
Mailing Address - Country:US
Mailing Address - Phone:360-675-4366
Mailing Address - Fax:888-862-1244
Practice Address - Street 1:751 SE BARRINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277
Practice Address - Country:US
Practice Address - Phone:360-675-4366
Practice Address - Fax:888-862-1244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6923122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty