Individual
KEAGAN WESTBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3624 W BASELINE RD STE 170, LAVEEN, AZ 85339-3044
(701) 367-8345
Mailing address
14603 S 24TH WAY, PHOENIX, AZ 85048-9021
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010761
AZ
Other
Enumeration date
07/19/2020
Last updated
07/19/2020
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