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Individual

CAROLYN KERINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS,PHD

Contact information

Practice address
3302 GASTON AVE, ROOM 203A, DALLAS, TX 75246-2013
(214) 828-8133
(214) 874-4508
Mailing address
3302 GASTON AVE, ROOM 203A, DALLAS, TX 75246-2013
(214) 828-8133
(214) 874-4508

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20883
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134162746
TX
05
126726206
TX
05
1295777324
TX
05
1457407181
TX
05
162250802
TX
05
162250804
TX
05
162250805
TX
01
20883
CDC CHIP
TX
Enumeration date
01/26/2007
Last updated
07/09/2007
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