Individual
DR. KEITH CYRUS KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4010 82ND ST, ELMHURST, NY 11373-1305
(718) 426-3333
Mailing address
549 E 234TH ST, APT 4C, BRONX, NY 10470-2454
(801) 319-0407
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
055988
NY
Other
Enumeration date
05/24/2011
Last updated
09/30/2014
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