Provider Demographics
NPI:1457846818
Name:PRICE, KERI LYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KERI
Middle Name:LYN
Last Name:PRICE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KERI
Other - Middle Name:LYN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1753 MCCUTCHEN RD
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-5423
Mailing Address - Country:US
Mailing Address - Phone:843-356-2955
Mailing Address - Fax:
Practice Address - Street 1:509 THURGOOD MARSHALL HWY
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-4107
Practice Address - Country:US
Practice Address - Phone:843-355-9295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDGD.9159122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist