Provider Demographics
NPI:1629396197
Name:PLAIN, KEITH DAVID (DMD)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:DAVID
Last Name:PLAIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3458 154A ST.
Mailing Address - Street 2:
Mailing Address - City:SURREY
Mailing Address - State:B.C.
Mailing Address - Zip Code:V3S 4C7
Mailing Address - Country:CA
Mailing Address - Phone:604-536-2328
Mailing Address - Fax:
Practice Address - Street 1:3458 154A ST.
Practice Address - Street 2:
Practice Address - City:SURREY
Practice Address - State:B.C.
Practice Address - Zip Code:V3S 4C7
Practice Address - Country:CA
Practice Address - Phone:604-536-2328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-08
Last Update Date:2010-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program