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General NPI Number Information
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NPI Number | 1801064043
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Entity Type | Individual
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Provider Name | SHERMAN BURTON BERGER DDS
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Gender | Male
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Dates
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Enumeration Date | 02/11/2008
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Last Update Date | 02/11/2008
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Provider Practice Location Address
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Address Line | 230 E RAVINE BAYE RD
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City | BAYSIDE
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State | WI
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Zip | 53217-1326
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Country | US
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Telephone | 414-352-8122
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Fax | 414-352-1535
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Provider Business Mailing Address
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Address Line | 230 E RAVINE BAYE RD
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City | BAYSIDE
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State | WI
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Zip | 53217-1326
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Country | US
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Telephone | 414-352-8122
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Fax | 414-352-1535
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5000750015
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License Number State | WI
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