Individual
DR. KEYSRA MARIE WASHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1336 N GALLOWAY AVE, MESQUITE, TX 75149-7417
(972) 329-5437
Mailing address
2944 NADAR, GRAND PRAIRIE, TX 75054-6728
(615) 293-4136
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN013140
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
852802311C
—
GA
Enumeration date
12/11/2006
Last updated
08/24/2012
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