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General NPI Number Information
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NPI Number | 1942419122
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Entity Type | Individual
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Provider Name | KEITH EDWARD CLEAR DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 10450 PARK MEADOWS DR SUITE 110
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City | LONE TREE
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State | CO
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Zip | 80124-5529
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Country | US
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Telephone | 720-502-3694
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Fax | 720-508-3280
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Provider Business Mailing Address
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Address Line | 10450 PARK MEADOWS DR SUITE 110
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City | LONE TREE
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State | CO
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Zip | 80124-5529
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Country | US
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Telephone | 720-502-3694
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Fax | 720-508-3280
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 6962
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License Number State | CO
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