Provider Demographics
NPI:1821427832
Name:JOSEPH D KEYES DDS LLC
Entity Type:Organization
Organization Name:JOSEPH D KEYES DDS LLC
Other - Org Name:ACORN DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:KEYES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:360-675-2942
Mailing Address - Street 1:230 SE CABOT DR STE 1
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3700
Mailing Address - Country:US
Mailing Address - Phone:360-675-2942
Mailing Address - Fax:360-675-8289
Practice Address - Street 1:230 SE CABOT DR STE 1
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3700
Practice Address - Country:US
Practice Address - Phone:360-675-2942
Practice Address - Fax:360-675-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-11
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60392932261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental