Provider Demographics
NPI:1659460368
Name:MCDUFFIE, DONALD KEITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:KEITH
Last Name:MCDUFFIE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5281
Mailing Address - Country:US
Mailing Address - Phone:256-547-4500
Mailing Address - Fax:256-547-4588
Practice Address - Street 1:427 S 4TH ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5281
Practice Address - Country:US
Practice Address - Phone:256-547-4500
Practice Address - Fax:256-547-4588
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL43911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics