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General NPI Number Information
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NPI Number | 1265731202
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Entity Type | Organization
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Legal Business Name | BARRY R. BERMAN, D.D.S., P.A.
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Dates
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Enumeration Date | 03/16/2011
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 110 PAINTERS MILL RD SUITE 8
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4920
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Country | US
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Telephone | 410-363-4422
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Fax | 410-581-1825
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Provider Business Mailing Address
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Address Line | 110 PAINTERS MILL RD SUITE 8
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4920
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Country | US
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Telephone | 410-363-4422
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Fax | 410-581-1825
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY RONALD BERMAN
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Credential | D.D.S.
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Telephone | 410-363-4422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4790
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License Number State | MD
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