Provider Demographics
NPI:1740393354
Name:KERR, ROBERT A (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:KERR
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 1:3269 CRAGGY PT SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4302
Mailing Address - Country:US
Mailing Address - Phone:770-436-6081
Mailing Address - Fax:
Practice Address - Street 1:1100 CIRCLE 75 PKWY SE
Practice Address - Street 2:200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3064
Practice Address - Country:US
Practice Address - Phone:770-980-0558
Practice Address - Fax:770-980-1092
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice