Individual
KEITH ROBERT FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1111 W VALLEY RD, APPLETON, WI 54915-1485
(920) 380-4055
(920) 380-4056
Mailing address
1111 W VALLEY RD, APPLETON, WI 54915-1485
(920) 380-4055
(920) 380-4056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1002679-15
WI
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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