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Individual
DR. KEITH YOUNG
Active
Individual
DR. KEITH YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15083
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y520500541410
DRIVER LICENSE
FL
Enumeration date
04/30/2008
Last updated
04/30/2008
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