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General NPI Number Information
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NPI Number | 1306801006
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Entity Type | Individual
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Provider Name | GREGORY JOHN KEISER DMD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/23/2019
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Provider Practice Location Address
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Address Line | 290 MADISON AVENUE
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City | MORRISTOWN
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State | NJ
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Zip | 07960
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Country | US
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Telephone | 973-538-5338
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Fax | 973-538-5343
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Provider Business Mailing Address
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Address Line | 25 MAUREEN ROAD
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City | EAST HANOVER
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State | NJ
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Zip | 07936
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Country | US
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Telephone | 973-515-9404
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Fax | 973-538-5343
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 16833
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS026629L
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License Number State | PA
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