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General NPI Number Information
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NPI Number | 1306024674
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Entity Type | Individual
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Provider Name | JILL ELIZABETH KEATON DMD
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Gender | Female
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Dates
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Enumeration Date | 02/08/2008
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 384 N MAYO TRL UNIT B
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City | PIKEVILLE
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State | KY
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Zip | 41501-1493
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Country | US
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Telephone | 606-437-7609
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Fax | 606-437-1085
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Provider Business Mailing Address
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Address Line | PO BOX 989
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City | PIKEVILLE
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State | KY
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Zip | 41502-0989
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Country | US
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Telephone | 606-437-7609
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Fax | 606-437-1085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6470
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License Number State | KY
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