Healthcare Provider Details

I. General information

NPI: 1336749522
Provider Name (Legal Business Name): BERMAN FAMILY DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9430 S MAIN ST STE 1
PLYMOUTH MI
48170-4149
US

IV. Provider business mailing address

9430 S MAIN ST STE 1
PLYMOUTH MI
48170-4149
US

V. Phone/Fax

Practice location:
  • Phone: 734-453-2200
  • Fax: 734-453-2318
Mailing address:
  • Phone: 734-453-2200
  • Fax: 734-453-2318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DONNA M SADOWSKI
Title or Position: OFFICE MGR
Credential:
Phone: 734-453-2200