Provider Demographics
NPI:1659531143
Name:PETERMAN, KERI A (DMD)
Entity Type:Individual
Prefix:DR
First Name:KERI
Middle Name:A
Last Name:PETERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 ROUTE 3A
Mailing Address - Street 2:SUITE 102
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025
Mailing Address - Country:US
Mailing Address - Phone:781-383-0003
Mailing Address - Fax:
Practice Address - Street 1:223 RT 3A
Practice Address - Street 2:SUITE 102
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025
Practice Address - Country:US
Practice Address - Phone:781-383-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18552211223P0221X
WI6621-151223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry