Provider Demographics
NPI:1275866972
Name:JOHN GERARD BERCIER DDS, MS, PC
Entity Type:Organization
Organization Name:JOHN GERARD BERCIER DDS, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:BERCIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:972-644-4867
Mailing Address - Street 1:8140 WALNUT HILL LN
Mailing Address - Street 2:201
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4350
Mailing Address - Country:US
Mailing Address - Phone:972-644-4867
Mailing Address - Fax:972-644-4860
Practice Address - Street 1:8140 WALNUT HILL LN
Practice Address - Street 2:201
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4350
Practice Address - Country:US
Practice Address - Phone:972-644-4867
Practice Address - Fax:972-644-4860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-12
Last Update Date:2009-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171771223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty