Individual
DR. GARY G. KEENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., P.A.
Contact information
Practice address
9509 HIGHWAY 107, SHERWOOD, AR 72120-2634
(501) 835-4655
(501) 835-4658
Mailing address
9509 HIGHWAY 107, SHERWOOD, AR 72120-2634
(501) 835-4655
(501) 835-4658
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2233
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58905
FEDERAL BLUE CROSS
AR
01
—
824306
BLUE CROSS BLUE SHIELD
AR
Enumeration date
09/28/2006
Last updated
07/08/2007
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