Healthcare Provider Details

I. General information

NPI: 1972509529
Provider Name (Legal Business Name): JAMES VINCENT KEENAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 04/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 TOWN BANK RD
NORTH CAPE MAY NJ
08204-4409
US

IV. Provider business mailing address

260 WILLOW DR
LITTLE SILVER NJ
07739-1540
US

V. Phone/Fax

Practice location:
  • Phone: 609-884-2969
  • Fax:
Mailing address:
  • Phone: 732-747-5124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI01398500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: