Provider Demographics
NPI:1063591063
Name:NLR ORAL & MAXILLOFACIAL SURGERY PLLC
Entity type:Organization
Organization Name:NLR ORAL & MAXILLOFACIAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-758-3095
Mailing Address - Street 1:3001 JFK BLVD
Mailing Address - Street 2:
Mailing Address - City:NO. LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116
Mailing Address - Country:US
Mailing Address - Phone:501-758-3095
Mailing Address - Fax:
Practice Address - Street 1:3001 JFK BLVD
Practice Address - Street 2:
Practice Address - City:NO. LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116
Practice Address - Country:US
Practice Address - Phone:501-758-3095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty