Provider Demographics
NPI:1760948244
Name:KEH DENTAL PLLC
Entity Type:Organization
Organization Name:KEH DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:HARP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:870-351-6959
Mailing Address - Street 1:82 COUNTY ROAD 781
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-6824
Mailing Address - Country:US
Mailing Address - Phone:870-351-6959
Mailing Address - Fax:
Practice Address - Street 1:8471 HWY 49 N
Practice Address - Street 2:
Practice Address - City:BROOKLAND
Practice Address - State:AR
Practice Address - Zip Code:72417
Practice Address - Country:US
Practice Address - Phone:870-351-6959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental