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General NPI Number Information
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NPI Number | 1992905186
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Entity Type | Individual
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Provider Name | SVETLANA BERMAN D.D.S., M.S.D.
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Gender | Female
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 704 ADAMS ST SUITE D
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City | CARMEL
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State | IN
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Zip | 46032-7541
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Country | US
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Telephone | 317-815-5552
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Fax | 317-815-5571
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Provider Business Mailing Address
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Address Line | 704 ADAMS ST SUITE D
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City | CARMEL
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State | IN
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Zip | 46032-7541
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Country | US
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Telephone | 317-815-5552
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Fax | 317-815-5571
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 12010665A
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License Number State | IN
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