Provider Demographics
NPI:1972180529
Name:KEAM, MOLLY (DDS)
Entity type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:
Last Name:KEAM
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 ALLEGHENY RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15139-1848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:256 E LAKE MEAD PKWY STE 200
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-6440
Practice Address - Country:US
Practice Address - Phone:702-703-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0433791223G0001X, 1223G0001X
NV80231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice