Provider Demographics
NPI:1861663205
Name:ZOLTAN T BERKY DDS MS PA
Entity Type:Organization
Organization Name:ZOLTAN T BERKY DDS MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ZOLTAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS, DIPLOMATE
Authorized Official - Phone:336-883-1616
Mailing Address - Street 1:1813 EASTCHESTER DR # 200
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1402
Mailing Address - Country:US
Mailing Address - Phone:336-883-1616
Mailing Address - Fax:
Practice Address - Street 1:1813 EASTCHESTER DR # 200
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1402
Practice Address - Country:US
Practice Address - Phone:336-883-1616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4996305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4996OtherLICENSE #