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Organization

DR. KEITH T. MACDONALD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH THOMAS MACDONALD D.D.S. (PRESIDENT)
(336) 434-3186
Entity
Organization

Contact information

Practice address
9924 US HIGHWAY 311, ARCHDALE, NC 27263-8826
(336) 434-3186
(336) 434-3189
Mailing address
9924 US HIGHWAY 311, ARCHDALE, NC 27263-8826
(336) 434-3186
(336) 434-3189

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4921
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95437
BCBS
NC
Enumeration date
02/25/2008
Last updated
02/25/2008
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