Provider Demographics
NPI:1689808834
Name:KEYS, KIMBERLY MORRIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MORRIS
Last Name:KEYS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 LIVINGSTON RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4918
Mailing Address - Country:US
Mailing Address - Phone:301-265-1650
Mailing Address - Fax:301-265-6509
Practice Address - Street 1:9500 LIVINGSTON RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4918
Practice Address - Country:US
Practice Address - Phone:301-265-1650
Practice Address - Fax:301-265-6509
Is Sole Proprietor?:No
Enumeration Date:2009-05-02
Last Update Date:2009-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice