Keith Raymon Acheson, DDS

Individual provider Active NPI General Practice Dentistry · Round Rock, TX

NPI 1275605487 · NPPES record last updated Mar 31, 2014

Key facts

NPI
1275605487
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0918 (TX)
Practice address
309 W Liberty Avenue
Round Rock, TX 78664
Phone
(512) 331-7000
Fax
(512) 238-1312
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
9801TXMDProfessional Counselor
0918TXMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0918 TX Yes

Addresses

Primary practice location

309 W Liberty Avenue
Round Rock, TX 78664

Mailing address

309 W Liberty Avenue
Round Rock, TX 78664
Phone (512) 331-7000

Other providers in Round Rock, TX

All providers in Round Rock, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.