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Individual

KEITH R BERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2936 E BARNETT RD, MEDFORD, OR 97504-8309
(541) 779-4517
(541) 779-4605
Mailing address
2936 E BARNETT RD, MEDFORD, OR 97504-8309
(541) 779-4517
(541) 779-4605

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D4310
OR

Other

Enumeration date
03/14/2007
Last updated
07/08/2007
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