Provider Demographics
NPI:1538365572
Name:KEENAN, ALLEN C (DDS)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:C
Last Name:KEENAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3808 E 51 ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135
Mailing Address - Country:US
Mailing Address - Phone:918-749-5033
Mailing Address - Fax:918-749-4394
Practice Address - Street 1:3808 E 51 ST
Practice Address - Street 2:SUITE E
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135
Practice Address - Country:US
Practice Address - Phone:918-749-5033
Practice Address - Fax:918-749-4394
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK29731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice