Individual
KEITH KISKADDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2226 DRUID RD E, CLEARWATER, FL 33764-4935
(727) 373-6628
Mailing address
2226 DRUID RD E, CLEARWATER, FL 33764-4935
(727) 373-6628
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20686
FL
Other
Enumeration date
11/17/2014
Last updated
07/06/2015
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