Provider Demographics
NPI:1386321487
Name:KEENER, NATALIE THERESA (DMD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:THERESA
Last Name:KEENER
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 1:111 17TH AVE S APT 708
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2782
Mailing Address - Country:US
Mailing Address - Phone:571-594-9513
Mailing Address - Fax:
Practice Address - Street 1:4502 CHARLOTTE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-3610
Practice Address - Country:US
Practice Address - Phone:615-647-8421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist