| Gary Keeler Dds, Oral Maxillofacial Surgery Llc | |
|
1000 Lakeland Square Ext Ste 700 Flowood MS 39232-7648 | |
| (601) 936-3555 | |
| (601) 936-3580 |
| Full Name | Gary Keeler Dds, Oral Maxillofacial Surgery Llc |
|---|---|
| Speciality | Clinic/center - Oral And Maxillofacial Surgery |
| Location | 1000 Lakeland Square Ext Ste 700, Flowood, Mississippi |
| Authorized Official Name and Position | Gary Keeler (OWNER/MANAGER) |
| Authorized Official Contact | 6019363555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Keeler Dds, Oral Maxillofacial Surgery Llc 1060 E County Line Rd Ste 3a-213 Ridgeland MS 39157-1900 Ph: (601) 936-3555 | Gary Keeler Dds, Oral Maxillofacial Surgery Llc 1000 Lakeland Square Ext Ste 700 Flowood MS 39232-7648 Ph: (601) 936-3555 |
| NPI Number | 1659626448 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 11/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659626448 | NPI | - | NPPES |
| 01880393 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 347808 (Mississippi) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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