Provider Demographics
NPI:1306074976
Name:BERGER, LOUIS CHRISTOPHER (DMD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:CHRISTOPHER
Last Name:BERGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2404 VIRGINIA BEACH BLVD STE 106
Mailing Address - Street 2:#106
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4059
Mailing Address - Country:US
Mailing Address - Phone:757-498-7878
Mailing Address - Fax:757-498-3427
Practice Address - Street 1:2404 VIRGINIA BEACH BLVD STE 106
Practice Address - Street 2:#106
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4059
Practice Address - Country:US
Practice Address - Phone:757-498-7878
Practice Address - Fax:757-498-3427
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014125341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice