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General NPI Number Information
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NPI Number | 1477320737
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Entity Type | Organization
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Legal Business Name | BERGES FAMILY DENTISTRY LLC
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Dates
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Enumeration Date | 12/07/2023
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 628 N SHORE RD
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City | ABSECON
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State | NJ
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Zip | 08201-1328
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Country | US
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Telephone | 609-484-8571
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Fax |
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Provider Business Mailing Address
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Address Line | 247 NEW JERSEY AVE
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City | ABSECON
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State | NJ
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Zip | 08201-2410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER, MANAGING MEMBER
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Name | DR. LOUIS JOHN BERGES III
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Credential | DMD
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Telephone | 609-457-9110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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