Provider Demographics
NPI:1962393850
Name:DR. J KEITH CONNELL, DMD
Entity type:Organization
Organization Name:DR. J KEITH CONNELL, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ASSOCIATE
Authorized Official - Prefix:DR
Authorized Official - First Name:NOLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-627-5659
Mailing Address - Street 1:1610 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2530
Mailing Address - Country:US
Mailing Address - Phone:256-383-5770
Mailing Address - Fax:
Practice Address - Street 1:1610 EDISON AVE
Practice Address - Street 2:
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-2530
Practice Address - Country:US
Practice Address - Phone:256-383-5770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty