Individual
DR. KEITH MESIDOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
50 IRVING ST NW, WASHINGTON, DC 20422-6257
(202) 745-8000
Mailing address
50 IRVING ST NW, DENTAL CLINIC, WASHINGTON, DC 20422-0001
(202) 745-8000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401416951
VA
1223G0001X
General Practice Dentistry
Primary
16952
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2019
Last updated
10/16/2023
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