Individual
RICHARD BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1181 OLD COUNTRY RD, SUITE 4, PLAINVIEW, NY 11803-5018
(516) 822-7880
(516) 822-5010
Mailing address
1181 OLD COUNTRY RD, SUITE 4, PLAINVIEW, NY 11803-5018
(516) 822-7880
(516) 822-5010
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
026825-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0038659994
—
NY
Enumeration date
08/05/2006
Last updated
07/08/2007
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