Individual
ETHAN E KERNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5995 IRIS PARKWAY, FREDERICK, CO 80530
(303) 833-2050
(303) 833-9183
Mailing address
203 S ROLLIE AVE, FORT LUPTON, CO 80621-1508
(303) 286-4560
(303) 286-4589
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN.00009471
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85757527
—
CO
Enumeration date
07/02/2007
Last updated
06/21/2016
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