Riley, Van Keith

Riley, Van Keith is an individual health care provider with primary practice located at 1454 Madison Ave W , Immokalee FL 34142-2200. He recently has only one registered license in Dental Providers / Dental Public Health, which is considered as his primary health care specialty. Riley, Van Keith can be contacted via phone (239) 658-3198.

Contact Information

Primary practice address
1454 Madison Ave W Immokalee FL 34142-2200
Phone: (239) 658-3198
Fax: (239) 658-3050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Public Health 1223D0001X D04687 Florida

Profile Details

NPI number 1083617484
LBN Legal business name Riley, Van Keith
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Mar 7th, 2023 - about 2 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 1083617484 NPPES
Florida Other D04687 DENTAL LICENSE

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