Individual
DR. KEENAN M DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
317 EDWIN DRIVE, VIRGINIA BEACH, VA 23462
(757) 499-2100
(757) 499-2999
Mailing address
317 EDWIN DRIVE, VIRGINIA BEACH, VA 23462
(757) 499-2100
(757) 499-2999
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
0401008797
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01398710
TRICARE
—
01
—
179331
ANTHEM
—
Enumeration date
03/29/2007
Last updated
07/08/2007
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