Healthcare Provider Details

I. General information

NPI: 1073516902
Provider Name (Legal Business Name): STEVEN C KEETON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 06/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DAMERON AVE
KNOXVILLE TN
37917-6413
US

IV. Provider business mailing address

9121 BRITISH STATION LN
KNOXVILLE TN
37922-9468
US

V. Phone/Fax

Practice location:
  • Phone: 865-215-5163
  • Fax: 865-215-5295
Mailing address:
  • Phone: 865-690-6651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberDS3794
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: