Provider Demographics
NPI:1831381409
Name:GARY F BERNARD DDS & ASSOCIATES PLLC
Entity type:Organization
Organization Name:GARY F BERNARD DDS & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-948-7000
Mailing Address - Street 1:7125 E LINCOLN DR
Mailing Address - Street 2:#103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253
Mailing Address - Country:US
Mailing Address - Phone:480-948-7000
Mailing Address - Fax:480-948-7531
Practice Address - Street 1:7125 E LINCOLN DR
Practice Address - Street 2:#103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253
Practice Address - Country:US
Practice Address - Phone:480-948-7000
Practice Address - Fax:480-948-7531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-16
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ60321223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty