Provider Demographics
NPI:1689701906
Name:KELLER, STEVEN HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HOWARD
Last Name:KELLER
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 1:11409 HOLLOW TREE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3600
Mailing Address - Country:US
Mailing Address - Phone:301-529-7459
Mailing Address - Fax:301-881-6723
Practice Address - Street 1:1734 ELTON RD STE 231
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-5722
Practice Address - Country:US
Practice Address - Phone:301-439-7878
Practice Address - Fax:301-434-3448
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD64161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice