Provider Demographics
NPI:1346972734
Name:BERKELHAMMER, MATTHEW GRAHAM (DDS)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GRAHAM
Last Name:BERKELHAMMER
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 1:116 S DRIVER ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-4134
Mailing Address - Country:US
Mailing Address - Phone:336-455-2624
Mailing Address - Fax:
Practice Address - Street 1:632 GARY ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-2299
Practice Address - Country:US
Practice Address - Phone:919-682-4861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-26
Last Update Date:2022-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12840122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist