Provider Demographics
NPI:1881428365
Name:KERR, RACHEL ANASTASIA (DMD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:ANASTASIA
Last Name:KERR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 SANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-2269
Mailing Address - Country:US
Mailing Address - Phone:570-343-4313
Mailing Address - Fax:570-504-0272
Practice Address - Street 1:1535 SANDERSON AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-2269
Practice Address - Country:US
Practice Address - Phone:570-343-4313
Practice Address - Fax:570-504-0272
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0447771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice