Keane, Thomas Maurice

Keane, Thomas Maurice is an sole proprietor health care provider with primary practice located at 8900 Penn Ave So. Suite 211, Bloomington MN 55431. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Keane, Thomas Maurice can be contacted via phone (952) 920-3844.

Contact Information

Primary practice address
8900 Penn Ave So. Suite 211 Bloomington MN 55431
Phone: (952) 920-3844
Fax: (952) 920-3008
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X 9671 Minnesota

Profile Details

NPI number 1891786224
LBN Legal business name Keane, Thomas Maurice
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2005
Last updated Jun 24th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891786224 NPPES
Minnesota MEDICAID 776322100

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