MEDICARE: ROBERT RICHARD KEEN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	#150870	NC

General Provider Information

NPI Number	:	1215294848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT RICHARD KEEN DDS

Provider Business Mailing Address
First Line	:	1915 WEST PARK DRIVE
Second Line	:	SUITE 104
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-3777
Country	:	US
Telephone Number	:	336-667-5170
Fax Number	:	336-903-7313

Provider Business Practice Location Address
First Line	:	1915 WEST PARK DRIVE
Second Line	:	SUITE #104
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-3777
Country	:	US
Telephone Number	:	336-667-5170
Fax Number	:	336-903-7313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2012
Last Update Date	:	04/12/2026

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