Healthcare Provider Details

I. General information

NPI: 1952562217
Provider Name (Legal Business Name): FRANK MICHAEL KERBL DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 EASTON CIR
FAIRHOPE AL
36532-6344
US

IV. Provider business mailing address

154 EASTON CIR
FAIRHOPE AL
36532-6344
US

V. Phone/Fax

Practice location:
  • Phone: 251-414-3031
  • Fax:
Mailing address:
  • Phone: 251-414-3031
  • Fax: 251-414-3039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number5667
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: