Provider Demographics
NPI:1598760514
Name:BERGER, SUZANNE PAULETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:PAULETTE
Last Name:BERGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28040 DOROTHY DR
Mailing Address - Street 2:STE 201
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-4916
Mailing Address - Country:US
Mailing Address - Phone:818-889-2061
Mailing Address - Fax:
Practice Address - Street 1:28040 DOROTHY DR
Practice Address - Street 2:STE 201
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-4916
Practice Address - Country:US
Practice Address - Phone:818-889-2061
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA256701223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry