Provider Demographics
NPI:1285807776
Name:KEATES, JAMES KEVIN (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:KEATES
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 1:494 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TOWNSHIP OF WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07676-4637
Mailing Address - Country:US
Mailing Address - Phone:201-664-5603
Mailing Address - Fax:
Practice Address - Street 1:494 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TOWNSHIP OF WASHINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07676-4637
Practice Address - Country:US
Practice Address - Phone:201-664-5603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI009933001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice