Provider Demographics
NPI:1134995145
Name:STERR, DON
Entity type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:STERR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 W PACES FERRY RD NW APT 541
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1327
Mailing Address - Country:US
Mailing Address - Phone:305-491-9764
Mailing Address - Fax:
Practice Address - Street 1:1305 CEDARCREST RD STE 115
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-8201
Practice Address - Country:US
Practice Address - Phone:678-257-7117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123296122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADN123296OtherDENTAL LICENSE