Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS037904 | PA |
N | 204E00000X | Oral & Maxillofacial Surgeon | MT191779 | PA |
NPI | 1124264023 |
---|---|
Provider Name | Dr. Joseph Frederick Kern |
First Address | Blue Bell, PA 19422-1276 |
Second Address | Bryn Mawr, PA 19010-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2008 |
Last Update Date | 06/03/2012 |