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General NPI Number Information
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NPI Number | 1073704482
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Entity Type | Individual
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Provider Name | MARCIE LYNN BERGER DMD
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Gender | Female
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 200 VILLAGE SQUARE XING SUITE 101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-3224
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Country | US
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Telephone | 561-626-9887
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Fax | 561-627-4451
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Provider Business Mailing Address
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Address Line | 200 VILLAGE SQUARE CROSSING SUITE 101
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-0122
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Country | US
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Telephone | 561-626-9887
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Fax | 561-627-4451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN16663
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 052964
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License Number State | NY
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