Provider Demographics
NPI:1942517529
Name:KERSHNER, KAREY ANN (RDH)
Entity Type:Individual
Prefix:MRS
First Name:KAREY
Middle Name:ANN
Last Name:KERSHNER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04967-3707
Mailing Address - Country:US
Mailing Address - Phone:207-487-4006
Mailing Address - Fax:207-487-3440
Practice Address - Street 1:453 MAIN ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:ME
Practice Address - Zip Code:04967-5310
Practice Address - Country:US
Practice Address - Phone:207-487-4006
Practice Address - Fax:207-487-3440
Is Sole Proprietor?:No
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2955124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist