Provider Demographics
NPI:1639437163
Name:MAYS, KEITH A (DDS, MS, PHD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:A
Last Name:MAYS
Suffix:
Gender:M
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LAKESIDE ANNEX 7, MS 701
Mailing Address - Street 2:EAST CAROLINA UNIVERSITY SCHOOL OF DENTISTRY
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834
Mailing Address - Country:US
Mailing Address - Phone:252-737-7037
Mailing Address - Fax:
Practice Address - Street 1:LAKESIDE ANNEX 7, MS 701
Practice Address - Street 2:EAST CAROLINA UNIVERSITY SCHOOL OF DENTISTRY
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834
Practice Address - Country:US
Practice Address - Phone:252-737-7037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC92671223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics