Individual
DR. DAVID ALEXANDER KEITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD BDS
Contact information
Practice address
15 PARKMAN ST, WAC 230 ORAL AND MAXILLOFACIAL SURGERY, BOSTON, MA 02114-3117
(617) 726-2740
(617) 726-2814
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
13914
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0253006
—
MA
01
—
701866
TUFTS HEALTH PLAN
MA
01
—
X04237
BCBS MA
MA
Enumeration date
10/31/2005
Last updated
07/08/2007
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