# KELLER CROSSING DENTISTRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699583476
- **Authorized official:** CHIYUAN CHEN DDS (OWNER)
- **Authorized official phone:** (682) 593-3198

## Contact information

- **Practice address:** 11751 ALTA VISTA RD STE 403, FORT WORTH, TX 76244-6441
- **Practice address phone:** (682) 593-3198
- **Mailing address:** 11751 ALTA VISTA RD STE 403, FORT WORTH, TX 76244-6441
- **Mailing address phone:** (682) 593-3198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 12/25/2024
- **Last updated:** 01/05/2025