Provider Demographics
NPI:1083796957
Name:BRIAN KERR DMD PS
Entity Type:Organization
Organization Name:BRIAN KERR DMD PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-584-6200
Mailing Address - Street 1:8520 STEILACOOM BLVD SW
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498
Mailing Address - Country:US
Mailing Address - Phone:253-584-6200
Mailing Address - Fax:253-984-6424
Practice Address - Street 1:8520 STEILACOOM BLVD SW
Practice Address - Street 2:SUITE 202
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498
Practice Address - Country:US
Practice Address - Phone:253-584-6200
Practice Address - Fax:253-984-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA7935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty