Provider Demographics
NPI:1609075092
Name:KERR, MAX OLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAX
Middle Name:OLEN
Last Name:KERR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:920 N VISTA RIDGE BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7637
Mailing Address - Country:US
Mailing Address - Phone:210-326-5744
Mailing Address - Fax:
Practice Address - Street 1:920 N VISTA RIDGE BLVD
Practice Address - Street 2:SUITE 700
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7637
Practice Address - Country:US
Practice Address - Phone:512-402-7811
Practice Address - Fax:512-777-4076
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX252021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice