| NPI | 1306461686 |
|---|---|
| Doing Business As | KEITH STREET ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JENNIFER A CLINE Credentialing Specialist 404-410-1340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-11 |