Provider Demographics
NPI:1568026730
Name:MCGRAIL, KERRI (DDS)
Entity Type:Individual
Prefix:DR
First Name:KERRI
Middle Name:
Last Name:MCGRAIL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKE GENEVA
Mailing Address - State:WI
Mailing Address - Zip Code:53147-4586
Mailing Address - Country:US
Mailing Address - Phone:262-248-4991
Mailing Address - Fax:
Practice Address - Street 1:851 PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:LAKE GENEVA
Practice Address - State:WI
Practice Address - Zip Code:53147-4586
Practice Address - Country:US
Practice Address - Phone:262-248-4991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist