Organization
KEILMAN DENTAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK N KEILMAN DDS (PRESIDENT)
(541) 296-1118
Entity
Organization
Contact information
Practice address
421 W 9TH ST, THE DALLES, OR 97058-1401
(541) 296-1118
Mailing address
421 W 9TH ST, THE DALLES, OR 97058-1401
(541) 296-1118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102673
—
OR
Enumeration date
06/19/2006
Last updated
08/22/2020
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