Individual
BRYCE MARK KEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9606 BASELINE RD, ALTA LOMA, CA 91701-5035
(909) 989-6661
(909) 989-6663
Mailing address
5029 LOMAS CT, RANCHO CUCAMONGA, CA 91737-1542
(909) 714-7105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105639
CA
Other
Enumeration date
10/02/2020
Last updated
10/02/2020
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