Provider Demographics
NPI:1164275798
Name:ROBERT E. BERGER D.D.S., CORPORATION
Entity Type:Organization
Organization Name:ROBERT E. BERGER D.D.S., CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-772-2840
Mailing Address - Street 1:215 N STATE COLLEGE BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-2933
Mailing Address - Country:US
Mailing Address - Phone:714-772-2840
Mailing Address - Fax:714-772-2841
Practice Address - Street 1:215 N STATE COLLEGE BLVD STE F
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92806-2933
Practice Address - Country:US
Practice Address - Phone:714-772-2840
Practice Address - Fax:714-772-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-11
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty