Provider Demographics
NPI:1134194673
Name:KERR, GRACE BALYOUT (DMD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:BALYOUT
Last Name:KERR
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 1:2752 ERIE AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2207
Mailing Address - Country:US
Mailing Address - Phone:513-533-4200
Mailing Address - Fax:513-533-4578
Practice Address - Street 1:2752 ERIE AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2207
Practice Address - Country:US
Practice Address - Phone:513-533-4200
Practice Address - Fax:513-533-4578
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH193291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics