Individual
KEVIN BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
6525 BURDEN BLVD, PASCO, WA 99301-9822
(509) 728-9460
Mailing address
6525 BURDEN BLVD, PASCO, WA 99301-9822
(509) 728-9460
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE60673881
WA
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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