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General NPI Number Information
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NPI Number | 1518033059
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Entity Type | Individual
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Provider Name | MATTHEW IAN KERR DDS
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 05/16/2012
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Provider Practice Location Address
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Address Line | 4300 E SUNSET RD #B 2
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City | HENDERSON
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State | NV
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Zip | 89014
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Country | US
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Telephone | 702-968-0707
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Fax | 702-968-0708
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Provider Business Mailing Address
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Address Line | 6040 S RAINBOW BLVD #B 2 ATTN NORIE CORPUZ
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City | LAS VEGAS
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State | NV
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Zip | 89118
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Country | US
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Telephone | 702-880-4266
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Fax | 702-792-4266
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 4841T
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License Number State | NV
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