Individual
ALEX BOHDAN BEREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
945 HORNBLEND, STE A, SAN DIEGO, CA 92109-4057
(858) 270-6855
(858) 270-6987
Mailing address
945 HORNBLEND, STE A, SAN DIEGO, CA 92109-4057
(858) 270-6855
(858) 270-6987
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22474
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
429481
UNITED CONCORDIA
CA
01
—
B2247401
DENTICAL
CA
Enumeration date
09/20/2006
Last updated
07/08/2007
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