Individual
KEITH LYNN MAYBERRY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1600 W WILSON RD, INDIAN HEAD, MD 20640-1400
(301) 744-4601
Mailing address
14708 BAUER DR, ROCKVILLE, MD 20853-3622
(301) 460-8490
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS024457L
PA
Other
Enumeration date
04/04/2006
Last updated
07/08/2007
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