Individual
DR. JENNIFER DARLENE KEYSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
600 LANIER AVE W STE 201, FAYETTEVILLE, GA 30214-1833
(770) 692-0453
Mailing address
600 LANIER AVE W STE 201, FAYETTEVILLE, GA 30214-1833
(770) 692-0453
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN015345
GA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS035140
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001615861
HIGHMARK BCBS
PA
05
—
101115006
—
PA
01
—
410390
UPMC HEALTH PLAN
PA
01
—
86957
GEISINGER HEALTH PLAN
PA
01
—
P00252465
MEDICARE RAILROAD
PA
Enumeration date
07/18/2006
Last updated
07/21/2022
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