Provider Demographics
NPI:1609103423
Name:BERMAN, RICHARD H (DMD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:BERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 BERKELEY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1334
Mailing Address - Country:US
Mailing Address - Phone:610-687-6950
Mailing Address - Fax:610-687-6955
Practice Address - Street 1:34 BERKELEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1334
Practice Address - Country:US
Practice Address - Phone:610-687-6950
Practice Address - Fax:610-687-6955
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028087L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice