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Individual

DR. MARK L. BERNSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
501 S PRESTON ST, SCHOOL OF DENTISTRY, SUITE 334, LOUISVILLE, KY 40292-0001
(502) 852-5083
(502) 852-5988
Mailing address
DEPT. OF SURGICAL AND HOSPITAL DENTISTRY, UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY, LOUISVILLE, KY 40292-0001
(502) 852-5083
(502) 852-5988

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4807
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000311546
ANTHEM BC BS
KY
01
4013501
ORAL PATH MEDICARE PIN
KY
01
50015221
PASSPORT HEALTH PLAN
KY
05
60003381
KY
01
9178936
DORAL DENTAL
KY
01
W01743
ORAL PATH LAB UPIN
KY
Enumeration date
05/11/2006
Last updated
11/07/2007
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