Provider Demographics
NPI:1851323943
Name:DR. ALAN J BERKO D.D.S., P.C.
Entity Type:Organization
Organization Name:DR. ALAN J BERKO D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-263-8388
Mailing Address - Street 1:418 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-3723
Mailing Address - Country:US
Mailing Address - Phone:978-263-8388
Mailing Address - Fax:978-635-3454
Practice Address - Street 1:418 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3723
Practice Address - Country:US
Practice Address - Phone:978-263-8388
Practice Address - Fax:978-635-3454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA137381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty