Organization
GARY KEELER DDS, ORAL MAXILLOFACIAL SURGERY LLC
Active
Other names
Gary Keeler DDS, Oral Maxillofacial Surgery LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY KEELER D.D.S. (OWNER/MANAGER)
(601) 936-3555
Entity
Organization
Contact information
Practice address
1000 LAKELAND SQUARE EXT STE 700, FLOWOOD, MS 39232-7648
(601) 936-3555
(601) 936-3580
Mailing address
1060 E COUNTY LINE RD STE 3A-213, RIDGELAND, MS 39157-1900
(601) 936-3555
(601) 936-3580
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
347808
MS
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01880393
—
MS
Enumeration date
07/17/2012
Last updated
11/08/2018
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