Provider Demographics
NPI:1558406132
Name:KERNAN, JOHN DUFFY (DMD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DUFFY
Last Name:KERNAN
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 1:554 BARTRAM ROAD
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057
Mailing Address - Country:US
Mailing Address - Phone:856-234-5214
Mailing Address - Fax:
Practice Address - Street 1:658 W CUTHBERT BLVD
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:NJ
Practice Address - Zip Code:08108-3642
Practice Address - Country:US
Practice Address - Phone:856-869-8660
Practice Address - Fax:856-869-8686
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01100200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist