Provider Demographics
NPI:1043335706
Name:STEPHEN P. KERPER D.D.S. & BRAD J. KANE D.D.S. A PROF. CORP.
Entity type:Organization
Organization Name:STEPHEN P. KERPER D.D.S. & BRAD J. KANE D.D.S. A PROF. CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KERPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-983-0245
Mailing Address - Street 1:1920 OUTLET CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036
Mailing Address - Country:US
Mailing Address - Phone:805-983-0245
Mailing Address - Fax:805-983-0341
Practice Address - Street 1:1920 OUTLET CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036
Practice Address - Country:US
Practice Address - Phone:805-983-0245
Practice Address - Fax:805-983-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty