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General NPI Number Information
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NPI Number | 1659531143
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Entity Type | Individual
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Provider Name | KERI A PETERMAN D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 223 RT 3A SUITE 102
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City | COHASSET
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State | MA
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Zip | 02025
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Country | US
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Telephone | 781-383-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 223 ROUTE 3A SUITE 102
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City | COHASSET
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State | MA
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Zip | 02025
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Country | US
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Telephone | 781-383-0003
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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 | DN1855221
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License Number State | MA
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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 | 6621-15
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License Number State | WI
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