Healthcare Provider Details

I. General information

NPI: 1477745057
Provider Name (Legal Business Name): BERNA SAGLIK D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N UNIVERSITY AVE
ANN ARBOR MI
48109-1078
US

IV. Provider business mailing address

1011 N UNIVERSITY AVE
ANN ARBOR MI
48109-1078
US

V. Phone/Fax

Practice location:
  • Phone: 734-763-3326
  • Fax:
Mailing address:
  • Phone: 734-274-0754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number2901019625
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: