Provider Demographics
NPI:1730138280
Name:SCHAMERLOH, KERRY ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:ALAN
Last Name:SCHAMERLOH
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 1:1133 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:IN
Mailing Address - Zip Code:46714-1324
Mailing Address - Country:US
Mailing Address - Phone:260-824-3100
Mailing Address - Fax:260-824-0018
Practice Address - Street 1:1133 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:IN
Practice Address - Zip Code:46714-1324
Practice Address - Country:US
Practice Address - Phone:260-824-3100
Practice Address - Fax:260-824-0018
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120076791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice