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General NPI Number Information
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NPI Number | 1376928739
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Entity Type | Organization
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Legal Business Name | THE DOCTORS BERGER FAMILY DENTISTRY
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Dates
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Enumeration Date | 07/28/2015
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 2404 VIRGINIA BEACH BLVD SUITE 106
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4059
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Country | US
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Telephone | 757-498-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 2404 VIRGINIA BEACH BLVD SUITE 106
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-4059
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Country | US
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Telephone | 757-498-7878
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. MISTY DAWN HOGGARD
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Credential |
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Telephone | 757-498-7878
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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 | 0401412534
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License Number State | VA
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