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General NPI Number Information
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NPI Number | 1114690880
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Entity Type | Organization
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Legal Business Name | MARY MORGAN BITLER KEYSER DDS MS PLLC
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Dates
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Enumeration Date | 07/29/2021
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Last Update Date | 07/29/2021
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Provider Practice Location Address
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Address Line | 106 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27608-1050
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Country | US
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Telephone | 919-782-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 106 LAKE BOONE TRL
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City | RALEIGH
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State | NC
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Zip | 27608-1050
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/PRACTICE OWNER
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Name | DR. MARY MORGAN BITLER KEYSER
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Credential | DDS, MS
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Telephone | 919-612-2647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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