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General NPI Number Information
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NPI Number | 1295465672
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Entity Type | Individual
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Provider Name | TYLER SCOTT KEMERER DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 100 BREWSTER BLVD
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City | CAMP LEJEUNE
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State | NC
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Zip | 28547-2575
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Country | US
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Telephone | 910-451-1658
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Fax |
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Provider Business Mailing Address
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Address Line | 3315 N GLEANER RD
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City | FREELAND
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State | MI
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Zip | 48623-8829
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Country | US
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Telephone | 989-860-4047
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2901601332
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License Number State | MI
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