Individual
DR. JOHN TENNIS KEAVENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS OMS
Contact information
Practice address
669 12TH ST W, SUITE 2, DICKINSON, ND 58601-3554
(701) 225-5163
(701) 264-1032
Mailing address
669 12TH ST W, SUITE 2, DICKINSON, ND 58601-3554
(701) 225-5163
(701) 264-1032
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
1444
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41384
—
ND
Enumeration date
08/02/2005
Last updated
05/21/2015
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