Organization
COUNTYLINE DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS KEANE DMD (PRESIDENT/ OWNER)
(954) 298-5582
Entity
Organization
Contact information
Practice address
21475 NW 2ND AVE, MIAMI, FL 33169-3316
(305) 654-1234
Mailing address
16600 SW 52ND PL, SOUTHWEST RANCHES, FL 33331-1340
(954) 298-5582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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