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General NPI Number Information
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NPI Number | 1114634086
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Entity Type | Organization
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Legal Business Name | KEY FAMILY DENTAL CENTER PLLC
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Dates
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Enumeration Date | 11/01/2022
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Last Update Date | 11/01/2022
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Provider Practice Location Address
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Address Line | 1099 HELMO AVE. N. SUITE 200
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City | OAKDALE
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State | MN
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Zip | 55128-6037
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Country | US
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Telephone | 651-770-9174
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Fax | 651-770-3839
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Provider Business Mailing Address
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Address Line | 1099 HELMO AVE. N. SUITE 200
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City | OAKDALE
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State | MN
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Zip | 55128-6037
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Country | US
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Telephone | 651-770-9174
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Fax | 651-770-3839
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | DR. KATHLEEN KELLY KEY
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Credential | D.D.S
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Telephone | 651-770-9174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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