Organization
BERKS ORAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN LYNN BAST (OFFICE MANAGER)
(610) 374-4093
Entity
Organization
Contact information
Practice address
1075 BERKSHIRE BLVD, SUITE 800, WYOMISSING, PA 19610-1264
(610) 374-4093
Mailing address
1075 BERKSHIRE BLVD, SUITE 800, WYOMISSING, PA 19610-1264
(610) 374-4093
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS-017170-L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS-017990-L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS024152-L
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS026002-L
PA
Other
Enumeration date
07/12/2006
Last updated
01/12/2009
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