Provider Demographics
NPI:1700977162
Name:DR KEITH A DEWINDT PA
Entity Type:Organization
Organization Name:DR KEITH A DEWINDT PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ADAMS
Authorized Official - Last Name:DEWINDT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-622-6100
Mailing Address - Street 1:2700 PGA BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-622-6100
Mailing Address - Fax:561-622-6107
Practice Address - Street 1:2700 PGA BLVD
Practice Address - Street 2:STE 202
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-622-6100
Practice Address - Fax:561-622-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN84111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty