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General NPI Number Information
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NPI Number | 1326037524
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Entity Type | Individual
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Provider Name | DOUGLAS G KERR DMD
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 10/03/2008
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Provider Practice Location Address
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Address Line | 3345 E BELL RD STE 1
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City | SCOTTSDALE
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State | AZ
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Zip | 65254
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Country | US
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Telephone | 480-607-3600
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Fax | 480-998-9289
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Provider Business Mailing Address
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Address Line | 12164 W FLORENCE ST
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City | TOLLESON
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State | AZ
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Zip | 85353-2746
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Country | US
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Telephone | 623-221-2573
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | D6332
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2000165443
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 9025376
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License Number State | IL
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