Provider Demographics
NPI:1386687564
Name:RANSDELL, KERRY L (DMD)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:L
Last Name:RANSDELL
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 1:507 BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:ME
Mailing Address - Zip Code:04539-3035
Mailing Address - Country:US
Mailing Address - Phone:207-563-6044
Mailing Address - Fax:207-563-6048
Practice Address - Street 1:507 BRISTOL RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:ME
Practice Address - Zip Code:04539-3035
Practice Address - Country:US
Practice Address - Phone:207-563-6044
Practice Address - Fax:207-563-6048
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice