Provider Demographics
NPI:1043230261
Name:KEEFE, JANICE T (DMD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:T
Last Name:KEEFE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4705
Mailing Address - Country:US
Mailing Address - Phone:781-356-1800
Mailing Address - Fax:781-356-9001
Practice Address - Street 1:369 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-4705
Practice Address - Country:US
Practice Address - Phone:781-356-1800
Practice Address - Fax:781-356-9001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA172421223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAXO6710OtherBC/BS OF MASSACHUSETTS ID