Individual
KEITH W DOTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12540 SW 68TH AVE, SUITE A, TIGARD, OR 97223-8597
(503) 620-5313
Mailing address
12540 SW 68TH AVE, SUITE A, TIGARD, OR 97223-8597
(503) 620-5313
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6165
OR
Other
Enumeration date
12/14/2008
Last updated
12/14/2008
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