Organization
SOUTH PENN PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH TREVOR BERG DDS (OWNER)
(208) 497-7250
Entity
Organization
Contact information
Practice address
7120 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-3315
(405) 681-6601
Mailing address
7120 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-3315
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/27/2025
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