Individual
DR. KEITH E SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
705 WINDY HILL RD SE, SMYRNA, GA 30080-1854
(770) 801-1641
(770) 801-0587
Mailing address
705 WINDY HILL RD SE, SMYRNA, GA 30080-1854
(770) 801-1641
(770) 801-0587
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN014208
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003122728B
—
GA
Enumeration date
05/25/2007
Last updated
07/26/2013
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