Provider Demographics
NPI:1710019708
Name:KEENER, LARRY DEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:DEAN
Last Name:KEENER
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 1:824 N SPRING ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2941
Mailing Address - Country:US
Mailing Address - Phone:870-741-7320
Mailing Address - Fax:870-741-3579
Practice Address - Street 1:824 N SPRING ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2941
Practice Address - Country:US
Practice Address - Phone:870-741-7320
Practice Address - Fax:870-741-3579
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice