Healthcare Provider Details

I. General information

NPI: 1972823995
Provider Name (Legal Business Name): JEFFERY B KESECKER DDS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2071 PRO POINTE LN
HARRISONBURG VA
22801-8021
US

IV. Provider business mailing address

2071 PRO POINTE LN
HARRISONBURG VA
22801-8021
US

V. Phone/Fax

Practice location:
  • Phone: 540-437-1230
  • Fax: 540-437-1218
Mailing address:
  • Phone: 540-437-1230
  • Fax: 540-437-1218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: BROOKE WILLIAMS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 540-437-1230