Provider Demographics
NPI:1578649919
Name:KEEN, DAVID D (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:D
Last Name:KEEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 N WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2844
Mailing Address - Country:US
Mailing Address - Phone:619-442-0983
Mailing Address - Fax:
Practice Address - Street 1:595 N WESTWIND DR
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2844
Practice Address - Country:US
Practice Address - Phone:619-442-0983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA035624122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist