Individual
DR. BLAKE CLETE KEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9606 BASE LINE RD, RANCHO CUCAMONGA, CA 91701-5035
(909) 989-6661
(909) 989-6663
Mailing address
PO BOX 9137, RANCHO CUCAMONGA, CA 91701-1137
(909) 989-6661
(909) 989-6663
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
111167
CA
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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