Provider Demographics
NPI:1457075038
Name:KEELS FAMILY AND COSMETIC DENTISTRY
Entity Type:Organization
Organization Name:KEELS FAMILY AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEELS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-661-6365
Mailing Address - Street 1:600 SQUIRES PT
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334-8868
Mailing Address - Country:US
Mailing Address - Phone:864-661-6365
Mailing Address - Fax:864-661-6370
Practice Address - Street 1:600 SQUIRES PT
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8868
Practice Address - Country:US
Practice Address - Phone:864-661-6365
Practice Address - Fax:864-661-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty