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General NPI Number Information
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NPI Number | 1578561130
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Entity Type | Individual
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Provider Name | DONALD ROY BERGER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 140 INVERNESS DR
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City | BLUE BELL
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State | PA
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Zip | 19422-3202
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Country | US
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Telephone | 215-896-7448
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Fax | 610-275-4103
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Provider Business Mailing Address
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Address Line | 140 INVERNESS DR
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City | BLUE BELL
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State | PA
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Zip | 19422-3202
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Country | US
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Telephone | 215-896-7448
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Fax | 610-275-4103
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI01053700
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License Number State | NJ
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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 | DS017607L
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License Number State | PA
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