Provider Demographics
NPI:1265731202
Name:BARRY R. BERMAN, D.D.S., P.A.
Entity type:Organization
Organization Name:BARRY R. BERMAN, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:BERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-363-4422
Mailing Address - Street 1:110 PAINTERS MILL RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4920
Mailing Address - Country:US
Mailing Address - Phone:410-363-4422
Mailing Address - Fax:410-581-1825
Practice Address - Street 1:110 PAINTERS MILL RD
Practice Address - Street 2:SUITE 8
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4920
Practice Address - Country:US
Practice Address - Phone:410-363-4422
Practice Address - Fax:410-581-1825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD47901223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty