Individual
DR. THOMAS MAURICE KEANE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8900 PENN AVE SO., SUITE 211, BLOOMINGTON, MN 55431
(952) 920-3844
(952) 920-3008
Mailing address
8900 PENN AVE SO., SUITE 211, BLOOMINGTON, MN 55431
(952) 920-3844
(952) 920-3008
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
9671
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
776322100
—
MN
Enumeration date
11/03/2005
Last updated
06/24/2015
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