MEDICARE: DR. STEPHEN RICHARD KEES 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
1	1223P0221X	Pediatric Dentistry	05319	KY

General Provider Information

NPI Number	:	1780686253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN RICHARD KEES DMD

Provider Business Mailing Address
First Line	:	2370 GRANDVIEW DR
Second Line	:
City	:	FT MITCHELL
State	:	KY
Zip	:	41017-1633
Country	:	US
Telephone Number	:	859-331-4449
Fax Number	:	859-331-4474

Provider Business Practice Location Address
First Line	:	2370 GRANDVIEW DR
Second Line	:
City	:	FT MITCHELL
State	:	KY
Zip	:	41017-1633
Country	:	US
Telephone Number	:	859-331-4449
Fax Number	:	859-331-4474

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

Provider Enumeration Date	:	08/13/2005
Last Update Date	:	07/08/2007

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