Provider Demographics
NPI:1831819994
Name:KEELAN DENTAL
Entity type:Organization
Organization Name:KEELAN DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREATMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RENWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-221-0854
Mailing Address - Street 1:264 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-2529
Mailing Address - Country:US
Mailing Address - Phone:724-285-4153
Mailing Address - Fax:724-283-9724
Practice Address - Street 1:264 NEW CASTLE RD
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2529
Practice Address - Country:US
Practice Address - Phone:724-285-4153
Practice Address - Fax:724-283-9724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty