Provider Demographics
NPI:1356545255
Name:KEELING, DAVID REED (DMD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:REED
Last Name:KEELING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5535 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1949
Mailing Address - Country:US
Mailing Address - Phone:414-529-3253
Mailing Address - Fax:844-529-5810
Practice Address - Street 1:5535 S 108TH ST
Practice Address - Street 2:
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130-1949
Practice Address - Country:US
Practice Address - Phone:414-529-3253
Practice Address - Fax:844-529-5810
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001372-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1001372-015OtherSTATE DENTAL LICENSE