MEDICARE: DR. LUIS G. KEYS DDS, MS

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	1223P0700X	Prosthodontics	5759	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5759	OTHER	AZ	DENTAL LICENSE NUMBER

General Provider Information

NPI Number	:	1447349485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LUIS G. KEYS DDS, MS

Provider Business Mailing Address
First Line	:	15601 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85739-9171
Country	:	US
Telephone Number	:	520-825-9305
Fax Number	:	520-825-2394

Provider Business Practice Location Address
First Line	:	15601 N ORACLE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85739-9171
Country	:	US
Telephone Number	:	520-825-9305
Fax Number	:	520-825-2394

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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