Provider Demographics
NPI:1578613311
Name:KERBS, ERIC LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:LYNN
Last Name:KERBS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 E VALLEY AUTO DR UNIT 10
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4605
Mailing Address - Country:US
Mailing Address - Phone:480-766-8486
Mailing Address - Fax:480-222-8084
Practice Address - Street 1:3050 E CHANDLER HEIGHTS RD STE 105
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85298-4325
Practice Address - Country:US
Practice Address - Phone:480-630-7266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice