Individual
DR. KEITH FELIX THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
16729 QUEEN ANNE RD, UPPER MARLBORO, MD 20774-8754
(301) 613-2430
Mailing address
16729 QUEEN ANNE RD, UPPER MARLBORO, MD 20774-8754
(301) 613-2430
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7399
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164519385
—
MD
Enumeration date
11/26/2010
Last updated
11/26/2010
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