Provider Demographics
NPI:1174760037
Name:SOMERSET DENTAL
Entity type:Organization
Organization Name:SOMERSET DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:KERBS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-988-7200
Mailing Address - Street 1:8490 S POWER RD STE 106
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-8029
Mailing Address - Country:US
Mailing Address - Phone:480-988-7200
Mailing Address - Fax:480-988-7318
Practice Address - Street 1:8490 S POWER RD STE 106
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8029
Practice Address - Country:US
Practice Address - Phone:480-988-7200
Practice Address - Fax:480-988-7318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty