Provider Demographics
NPI:1295727402
Name:ZERR, KENT S (DMD)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:S
Last Name:ZERR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 25TH ST SE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1279
Mailing Address - Country:US
Mailing Address - Phone:503-370-8778
Mailing Address - Fax:503-370-8628
Practice Address - Street 1:2601 25TH ST SE
Practice Address - Street 2:SUITE 430
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1279
Practice Address - Country:US
Practice Address - Phone:503-370-8778
Practice Address - Fax:503-370-8628
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD56481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU54599Medicare UPIN