# KEEGAN JOSEPH WALDO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1821526708
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | RR60670198 | WA | — |
| 1223G0001X | General Practice Dentistry | DE60769612 | WA | Yes |

## Other

- **Enumeration date:** 05/23/2017
- **Last updated:** 07/21/2022