Individual
DR. VAN KEITH RILEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1454 MADISON AVE W, IMMOKALEE, FL 34142-2200
(239) 658-3198
(239) 658-3050
Mailing address
330 HAWSER LN, NAPLES, FL 34102-5031
(239) 262-5309
(239) 262-1939
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
D04687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D04687
DENTAL LICENSE
FL
Enumeration date
05/31/2005
Last updated
03/07/2023
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