Provider Demographics
NPI:1588676068
Name:BERG & BIRONG DDS LLC
Entity Type:Organization
Organization Name:BERG & BIRONG DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-627-5666
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:1040 TRUMP RD ST A
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615
Mailing Address - Country:US
Mailing Address - Phone:330-627-5666
Mailing Address - Fax:330-627-7889
Practice Address - Street 1:1040 TRUMP RD
Practice Address - Street 2:ST A
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615
Practice Address - Country:US
Practice Address - Phone:330-627-5666
Practice Address - Fax:330-627-7889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty