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Individual

DR. KEITH YOUNG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
5381 N SOCRUM LOOP RD, LAKELAND, FL 33809-4272
(863) 815-3313
(863) 816-8750
Mailing address
5381 N SOCRUM LOOP RD, LAKELAND, FL 33809-4272
(863) 815-3313
(863) 816-8750

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15083
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
Y520500541410
DRIVER LICENSE
FL
Enumeration date
04/30/2008
Last updated
04/30/2008
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