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Individual

DR. JOHN J KEATING IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3821 W PUEBLO BLVD, PUEBLO, CO 81005-2713
(719) 564-6467
Mailing address
3821 W PUEBLO BLVD, PUEBLO, CO 81005-2713

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
22DI02497500
NJ
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00203355
CO

Other

Enumeration date
05/03/2012
Last updated
03/17/2018
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