Organization
KENNETH M. BERRIN, DDS, INC.
Active
Other names
Community Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MARK BERRIN DDS (DENTIST)
(858) 486-2224
Entity
Organization
Contact information
Practice address
13132B POWAY RD, POWAY, CA 92064-4612
(858) 486-2224
(858) 486-2317
Mailing address
13132B POWAY RD, POWAY, CA 92064-4612
(858) 486-2224
(858) 486-2317
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
29775
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255338190
NPI NUMBER
CA
01
—
29775
STATE LICENSE
CA
Enumeration date
07/08/2013
Last updated
07/08/2013
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