Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN 0011470 | FL |
NPI | 1164543070 |
---|---|
Provider Name | Dr. Kenneth J Kerman |
First Address | Deerfield Beach, FL 33441-4206 |
Second Address | Deerfield Beach, FL 33441-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2007 |