Provider Demographics
NPI:1164160487
Name:JONATHAN SCOTT BERNS DDS PLLC
Entity Type:Organization
Organization Name:JONATHAN SCOTT BERNS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BERNS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-701-6871
Mailing Address - Street 1:278 N BURGESS ST
Mailing Address - Street 2:
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-1108
Mailing Address - Country:US
Mailing Address - Phone:989-345-0802
Mailing Address - Fax:
Practice Address - Street 1:278 N BURGESS ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-1108
Practice Address - Country:US
Practice Address - Phone:989-345-0802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental