Individual
KELLY KEEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8404 DORSEY CIR, MANASSAS, VA 20110-4592
(703) 330-5755
Mailing address
8404 DORSEY CIR, MANASSAS, VA 20110-4592
(703) 330-5755
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401413738
VA
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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