Organization
FREDERICKSBURG SQUARE DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID L KEETON DDS (PRESIDENT)
(210) 500-7577
Entity
Organization
Contact information
Practice address
3949 FREDERICKSBURG RD, SAN ANTONIO, TX 78201-3231
(210) 326-5546
Mailing address
145 RANCH DR, BOERNE, TX 78015-8319
(210) 326-5546
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22842
TX
Other
Enumeration date
10/29/2015
Last updated
09/13/2024
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