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General NPI Number Information
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NPI Number | 1326267675
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Entity Type | Individual
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Provider Name | ALANA M KEOUGH HUMBERSON DMD
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 3379 OCEAN DRIVE
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City | VERO BEACH
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State | FL
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Zip | 32963
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Country | US
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Telephone | 772-234-3333
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Fax | 772-234-1509
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Provider Business Mailing Address
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Address Line | 3379 OCEAN DRIVE
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City | VERO BEACH
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State | FL
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Zip | 32963
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Country | US
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Telephone | 772-234-3333
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Fax | 772-234-1509
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN 16740
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN-16740
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License Number State | FL
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