Provider Demographics
NPI:1053339101
Name:KERR, STEPHEN (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:KERR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 WATER ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4041
Mailing Address - Country:US
Mailing Address - Phone:508-747-5400
Mailing Address - Fax:508-747-8369
Practice Address - Street 1:233 WATER ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4041
Practice Address - Country:US
Practice Address - Phone:508-747-5400
Practice Address - Fax:508-747-8369
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice