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Individual

FREDERICK PORTER BERINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
703 S RANGE AVE, DENHAM SPRINGS, LA 70726-4414
(225) 664-7175
Mailing address
703 S RANGE AVE, DENHAM SPRINGS, LA 70726-4414
(225) 664-7175

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2627
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1826278
LA
Enumeration date
03/07/2007
Last updated
07/09/2007
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