Provider Demographics
NPI:1447349485
Name:KEYS, LUIS G (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:G
Last Name:KEYS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15601 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9171
Mailing Address - Country:US
Mailing Address - Phone:520-825-9305
Mailing Address - Fax:520-825-2394
Practice Address - Street 1:15601 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9171
Practice Address - Country:US
Practice Address - Phone:520-825-9305
Practice Address - Fax:520-825-2394
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ57591223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5759OtherDENTAL LICENSE NUMBER