Provider Demographics
NPI:1750063954
Name:FOREST, KERRI ANN
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:ANN
Last Name:FOREST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 41 BOX 2735
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09464-0028
Mailing Address - Country:US
Mailing Address - Phone:777-034-5347
Mailing Address - Fax:
Practice Address - Street 1:944 RAF LAKENHEATH BRANDON ROAD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:BRANDON
Practice Address - Zip Code:IP27 9PN
Practice Address - Country:GB
Practice Address - Phone:777-034-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant