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Individual

LINA MARIA BERMUDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
343 MAIN STREET, GREAT BARRINGTON, MA 01230
(413) 528-5565
(413) 528-5564
Mailing address
P.O. BOX 30, GREAT BARRINGTON, MA 01230
(413) 528-9311
(413) 644-0274

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10558
MA
1223G0001X
General Practice Dentistry
Primary
DL13088
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110114758A
MA
01
DL10558
MASSACHUSETTS LICENSE
MA
Enumeration date
03/31/2009
Last updated
07/21/2022
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