Provider Demographics
NPI:1164543070
Name:KERMAN, KENNETH J (DMD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:J
Last Name:KERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1348 E HILLSBORO BLVD
Mailing Address - Street 2:SUIT B
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-4206
Mailing Address - Country:US
Mailing Address - Phone:954-428-0081
Mailing Address - Fax:954-482-4470
Practice Address - Street 1:1348 E HILLSBORO BLVD
Practice Address - Street 2:SUIT B
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-4206
Practice Address - Country:US
Practice Address - Phone:954-428-0081
Practice Address - Fax:954-482-4470
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 00114701223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics