Individual
DR. MARK THOMAS KEYDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
52 COLCHESTER AVE, BURLINGTON, VT 05401
(802) 864-0353
(802) 865-9414
Mailing address
27 CABOT COURT, SOUTH BURLINGTON, VT 05403
(802) 658-9981
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
VT851
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002450
—
VT
Enumeration date
02/12/2007
Last updated
07/08/2007
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