Provider Demographics
NPI:1366563553
Name:TOWNSEND, KEIR BRUCE (DDS)
Entity type:Individual
Prefix:DR
First Name:KEIR
Middle Name:BRUCE
Last Name:TOWNSEND
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 1:601 N VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-5223
Mailing Address - Country:US
Mailing Address - Phone:507-387-2502
Mailing Address - Fax:507-345-4378
Practice Address - Street 1:601 N VICTORY DR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-5223
Practice Address - Country:US
Practice Address - Phone:507-387-2502
Practice Address - Fax:507-345-4378
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN93541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice