| NPI | 1073784880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN KEITH KEEN Surgeon/Owner 601-661-0034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MS 2951-96) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |