Provider Demographics
NPI:1811090392
Name:KEENAN, DANIEL PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:KEENAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 LAFAYETTE RD
Mailing Address - Street 2:PVT BUILDING
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:603-436-9004
Mailing Address - Fax:603-436-5204
Practice Address - Street 1:545 LAFAYETTE RD
Practice Address - Street 2:PVT BUILDING
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-436-9004
Practice Address - Fax:603-436-5204
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH2416122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist