Provider Demographics
NPI:1770655474
Name:DR KEITH D MCGRANAHAN DDS APC
Entity Type:Organization
Organization Name:DR KEITH D MCGRANAHAN DDS APC
Other - Org Name:KEITH DEAN MCGRANAHAN DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:MCGRANAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:907-278-1050
Mailing Address - Street 1:1407 W 31ST SUITE 601
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3661
Mailing Address - Country:US
Mailing Address - Phone:907-278-1505
Mailing Address - Fax:907-276-8284
Practice Address - Street 1:1407 W 31ST SUITE 601
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3661
Practice Address - Country:US
Practice Address - Phone:907-278-1505
Practice Address - Fax:907-276-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAK3101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty