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General NPI Number Information
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NPI Number | 1962292649
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Entity Type | Organization
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Legal Business Name | DYLAN J. KEENER, D.M.D., M.S., P.C.
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 240 HYDRAULIC RIDGE RD STE 202
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-8130
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Country | US
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Telephone | 434-973-6542
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Fax |
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Provider Business Mailing Address
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Address Line | 2639 HOLKHAM DR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-9527
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Country | US
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Telephone | 717-507-2685
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST/OWNER
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Name | DR. DYLAN JAMES KEENER
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Credential | DMD
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Telephone | 717-507-2685
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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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