Organization Name: | KEITH W. COWHEY, DDS, INC |
NPI Number: | 1134510431 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEITH COWHEY (PRESIDENT) |
Mailing Address: | 400 5th St Seal Beach |
State: | CA US |
Postal Code: | 907405967 |
Phone Number: | 5624312929 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2015 |
NPI Last Update Date: | 02/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 58482 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |