Provider Demographics
NPI:1023499019
Name:KERWAR, KERRY (DMD)
Entity type:Individual
Prefix:DR
First Name:KERRY
Middle Name:
Last Name:KERWAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 POLARIS CIR
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5472
Mailing Address - Country:US
Mailing Address - Phone:415-845-0543
Mailing Address - Fax:
Practice Address - Street 1:1 POLARIS CIR
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-5472
Practice Address - Country:US
Practice Address - Phone:415-845-0543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856585122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist