Organization Name: | KELLER PEDIATRIC DENTISTRY |
NPI Number: | 1043471311 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL E DONOHUE (DENTIST) |
Mailing Address: | 1858 Keller Pkwy Suite 100 Keller |
State: | TX US |
Postal Code: | 762483757 |
Phone Number: | 8174316008 |
Fax Number: | 8173370098 |
NPI Enumeration Date: | 06/19/2008 |
NPI Last Update Date: | 06/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 14921 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |