Provider Demographics
NPI:1437276987
Name:BERKSON, ALAN J (D D S)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:BERKSON
Suffix:
Gender:M
Credentials:D D S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3615
Mailing Address - Country:US
Mailing Address - Phone:203-877-5106
Mailing Address - Fax:203-877-8173
Practice Address - Street 1:431 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3615
Practice Address - Country:US
Practice Address - Phone:203-877-5106
Practice Address - Fax:203-877-8173
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52601223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics