Healthcare Provider Details

I. General information

NPI: 1861663205
Provider Name (Legal Business Name): ZOLTAN T BERKY DDS MS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2008
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 EASTCHESTER DR # 200
HIGH POINT NC
27265-1402
US

IV. Provider business mailing address

1813 EASTCHESTER DR # 200
HIGH POINT NC
27265-1402
US

V. Phone/Fax

Practice location:
  • Phone: 336-883-1616
  • Fax:
Mailing address:
  • Phone: 336-883-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number4996
License Number StateNC

VIII. Authorized Official

Name: ZOLTAN T BERKY
Title or Position: DR/PRESIDENT
Credential: DDS, MS, DIPLOMATE
Phone: 336-883-1616