Individual
MRS. ROBERTA ELLEN KERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD, MPH, MS
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9648
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9648
DENTAL LICENSE
AZ
Enumeration date
09/07/2012
Last updated
01/15/2019
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