Provider Demographics
NPI:1033826086
Name:GLORIA JAMES KERRY, D.D.S., M.S.
Entity Type:Organization
Organization Name:GLORIA JAMES KERRY, D.D.S., M.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KLYNSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-995-0515
Mailing Address - Street 1:3250 PLYMOUTH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2555
Mailing Address - Country:US
Mailing Address - Phone:734-995-0515
Mailing Address - Fax:734-995-1299
Practice Address - Street 1:3250 PLYMOUTH RD STE 104
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2555
Practice Address - Country:US
Practice Address - Phone:734-995-0515
Practice Address - Fax:734-995-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental