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Individual

MR. DARCY CAMERON KERR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.D. (LICENSED DENTU

Contact information

Practice address
1155 POCATELLO CREEK RD., POCATELLO, ID 83201
(208) 238-1100
(208) 233-4933
Mailing address
1155 POCATELLO CREEK RD., POCATELLO, ID 83201
(208) 238-1100
(208) 233-4933

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
54
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806654100
ID
Enumeration date
04/03/2007
Last updated
04/15/2019
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