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Organization
MARK D. BERARD, DDS, PC
Active
Organization
MARK D. BERARD, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK DANIEL BERARD D.D.S. (DENTIST/OWNER)
(616) 392-2853
Entity
Organization
Contact information
Practice address
203 WEST 30TH STREET, HOLLAND, MI 49423
(616) 392-2853
(616) 392-2568
Mailing address
203 WEST 30TH STREET, HOLLAND, MI 49423
(616) 392-2853
(616) 392-2568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
02097814533
MI
1223G0001X
General Practice Dentistry
Primary
2901019128
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1884295
UNITED CONCORDIA
—
01
—
625904
UNITED CONCORDIA
—
01
—
D145330
BCBSM
MI
01
—
D801446
BCBSM
—
Enumeration date
12/01/2006
Last updated
02/03/2011
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