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General NPI Number Information
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NPI Number | 1407936438
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Entity Type | Individual
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Provider Name | LIOR BERGER DMD
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 09/20/2007
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Provider Practice Location Address
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Address Line | 2730 S VAL VISTA DR BUILDING #11, SUITE #164
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City | GILBERT
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State | AZ
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Zip | 85295-1675
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Country | US
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Telephone | 480-633-9977
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Fax |
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Provider Business Mailing Address
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Address Line | 413 E VAUGHN AVE
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City | GILBERT
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State | AZ
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Zip | 85234-6451
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Country | US
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Telephone | 480-205-0222
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Fax |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | AZ5756
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License Number State | AZ
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