Provider Demographics
NPI:1841020971
Name:BERGER, COURTNEY (RDH)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 PINEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2500
Mailing Address - Country:US
Mailing Address - Phone:810-875-6426
Mailing Address - Fax:
Practice Address - Street 1:4252 S LINDEN RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2953
Practice Address - Country:US
Practice Address - Phone:810-733-1890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902018248124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist