Provider Demographics
NPI:1598822652
Name:KEEFER, OLIVER
Entity Type:Individual
Prefix:DR
First Name:OLIVER
Middle Name:
Last Name:KEEFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 THIERER RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-3718
Mailing Address - Country:US
Mailing Address - Phone:608-244-6888
Mailing Address - Fax:608-244-2372
Practice Address - Street 1:1734 THIERER RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-3718
Practice Address - Country:US
Practice Address - Phone:608-244-6888
Practice Address - Fax:608-244-2372
Is Sole Proprietor?:No
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI58871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice