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DR. KANYON R. KEENEY DDS

Physicians Oral & Maxillofacial Surgery

Provider NPI: 1043271935

Provider Information:
DR. KANYON R. KEENEY DDS
Gender: M
Not Sole Proprietor

Practice Location:
7481 RIGHT FLANK RD STE 120  MECHANICSVILLE, VA 23116 US
Tel: 804-559-5416  Fax: 804-559-5455

Business Mailing Address:
11545-A NUCKOLS ROAD  GLEN ALLEN, VA 23059 US
Tel: 804-673-8061  Fax: 804-673-5644

NPI Information:
NPI: 1043271935
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y204E00000XPhysicians
Oral & Maxillofacial Surgery
VA0438000164
N1223S0112XDental Providers
Dentist
VA0401006889

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 204E00000X

Type:

Classification:



Definition:



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