Provider Demographics
NPI:1518086362
Name:ROMIG, KERRY (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:
Last Name:ROMIG
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 COMMERCE DR
Mailing Address - Street 2:SUITE 3309
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7151
Mailing Address - Country:US
Mailing Address - Phone:781-249-3238
Mailing Address - Fax:
Practice Address - Street 1:501 COMMERCE DR
Practice Address - Street 2:SUITE 3309
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7151
Practice Address - Country:US
Practice Address - Phone:781-249-3238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12700124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist