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Individual

DR. M BERT KEEL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
304 N 2ND ST, BAY ST LOUIS, MS 39520-4538
(228) 467-5577
(228) 467-0468
Mailing address
304 N 2ND ST, BAY ST LOUIS, MS 39520-4538
(228) 467-5577
(228) 467-0468

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1933-81
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
640701713
TAX IDENTIFICATION NUMBER
MS
Enumeration date
09/28/2006
Last updated
07/08/2007
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