Individual
DR. KEITH EDWIN MOOMAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1308 BUSINESS CENTER WAY, SUITE 105, EDGEWOOD, MD 21040-1504
(410) 679-2790
Mailing address
1308 BUSINESS CENTER WAY, SUITE 105, EDGEWOOD, MD 21040-1504
(410) 679-2790
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
MD6960
MD
Other
Enumeration date
04/11/2007
Last updated
07/08/2007
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