Individual
DR. MICHELLE C. KEYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-3410
(503) 988-5903
Mailing address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7076
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182468
—
OR
Enumeration date
10/18/2006
Last updated
07/08/2007
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