Individual
BRYCE KEELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
314 WOODHAVEN DR, TOMPKINSVILLE, KY 42167-1879
(270) 407-1997
Mailing address
314 WOODHAVEN DR, TOMPKINSVILLE, KY 42167-1879
(270) 407-1997
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10943
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2023
Last updated
04/12/2024
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