Provider Demographics
NPI:1144392515
Name:KERR, MARK A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:KERR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1355 S HIGLEY RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:HIGLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85236
Mailing Address - Country:US
Mailing Address - Phone:480-545-4120
Mailing Address - Fax:480-545-4123
Practice Address - Street 1:1355 S HIGLEY RD
Practice Address - Street 2:SUITE 116
Practice Address - City:HIGLEY
Practice Address - State:AZ
Practice Address - Zip Code:85236
Practice Address - Country:US
Practice Address - Phone:480-545-4120
Practice Address - Fax:480-545-4123
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53561223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics