Provider Demographics
NPI:1255484184
Name:BERGER, PAUL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
Last Name:BERGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103400 OVERSEAS HWY STE 229
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2849
Mailing Address - Country:US
Mailing Address - Phone:305-453-1811
Mailing Address - Fax:
Practice Address - Street 1:103400 OVERSEAS HWY STE 229
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-2849
Practice Address - Country:US
Practice Address - Phone:305-453-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 45221223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics