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NPI Code Detail

MEDICARE: DR. KEITH H. FOSTER DMD

MEDICARE: DR. KEITH H. FOSTER DMD
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
11223E0200XEndodontics7425TN

General Provider Information

NPI Number : 1649251828
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH H. FOSTER DMD
Provider Business Mailing Address
First Line : 206 SIMMONS ST
Second Line :
City : MARYVILLE
State : TN
Zip : 37801-4750
Country : US
Telephone Number : 865-984-0104
Fax Number : 865-984-0188
Provider Business Practice Location Address
First Line : 206 SIMMONS ST
Second Line :
City : MARYVILLE
State : TN
Zip : 37801-4750
Country : US
Telephone Number : 865-984-0104
Fax Number : 865-984-0188
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 07/08/2007

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Directions to “ DR. KEITH H. FOSTER DMD” Practice Location

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