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Organization
SHANNON KEYES DMD LLC
Active
Organization
SHANNON KEYES DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON M KEYES DMD (DENTIST)
(609) 971-7900
Entity
Organization
Contact information
Practice address
34 MANCHESTER AVE, SUITE 204, FORKED RIVER, NJ 08731-1366
(609) 971-7900
(609) 971-7799
Mailing address
34 MANCHESTER AVE, SUITE 204, FORKED RIVER, NJ 08731-1366
(609) 971-7900
(609) 971-7799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DIO2191700
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
22DIO101150701
NJ
Other
Enumeration date
10/20/2014
Last updated
10/20/2014
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