Individual
MARY LOIS KEEZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1023 ATLANTIC BLVD, ATLANTIC BEACH, FL 32233-3313
(904) 249-3104
(904) 249-3109
Mailing address
600 TECHNOLOGY PARK STE 101, LAKE MARY, FL 32746-7122
(407) 543-8509
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN25313
FL
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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