Provider Demographics
NPI:1073023453
Name:KERN FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:KERN FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-352-2013
Mailing Address - Street 1:21 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAFTON
Mailing Address - State:ND
Mailing Address - Zip Code:58237-1468
Mailing Address - Country:US
Mailing Address - Phone:701-352-2013
Mailing Address - Fax:701-352-3389
Practice Address - Street 1:21 W 5TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1468
Practice Address - Country:US
Practice Address - Phone:701-352-2013
Practice Address - Fax:701-352-3389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1871261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental