Provider Demographics
NPI:1083777593
Name:PATRICK A BERNARDI DMD MS PC
Entity Type:Organization
Organization Name:PATRICK A BERNARDI DMD MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CORP PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BERNANDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:256-835-5355
Mailing Address - Street 1:227 CHOCCOLOCCO STR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203
Mailing Address - Country:US
Mailing Address - Phone:256-835-5355
Mailing Address - Fax:
Practice Address - Street 1:227 CHOCCOLOCCO STR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:AL
Practice Address - Zip Code:36203
Practice Address - Country:US
Practice Address - Phone:256-835-5355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty