Organization
DR. KEITH EVELAND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH WARE EVELAND (OWNER)
(603) 433-5677
Entity
Organization
Contact information
Practice address
111 BOW STREET, PORTSMOUTH, NH 03801
(603) 433-5677
(603) 433-6279
Mailing address
111 BOW ST, PORTSMOUTH, NH 03801
(603) 433-5677
(603) 433-6279
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1219
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89191631
—
NH
Enumeration date
04/13/2007
Last updated
08/22/2020
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