Provider Demographics
NPI:1992712814
Name:CARINI, KEITH CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:KEITH
Middle Name:CHARLES
Last Name:CARINI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9409 FORTY RD
Mailing Address - Street 2:
Mailing Address - City:CATTARAUGUS
Mailing Address - State:NY
Mailing Address - Zip Code:14719
Mailing Address - Country:US
Mailing Address - Phone:716-257-5820
Mailing Address - Fax:716-257-3280
Practice Address - Street 1:44 MAIN ST
Practice Address - Street 2:
Practice Address - City:CATTARAUGUS
Practice Address - State:NY
Practice Address - Zip Code:14719
Practice Address - Country:US
Practice Address - Phone:716-257-9049
Practice Address - Fax:716-257-3280
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031297122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist