Southern Oral and Maxillofacial Surgery Center, INC
NPI #1073784880 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1073784880
- Entity Type
- Organization
- Organization Name
- Southern Oral and Maxillofacial Surgery Center, INC
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Mar 19, 2008
- Last Updated
- Mar 19, 2008
Practice Location
- Address
- 1205 MISSION PARK DR
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-3747
- Phone
- (601) 661-0034
Authorized Official
- Name
- DR. KEVIN KEITH KEEN, DMD
- Title
- SURGEON/OWNER
- Phone
- (601) 661-0034
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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