Provider Demographics
NPI:1306943543
Name:BERGER, JOEL STEPHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:STEPHEN
Last Name:BERGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1890 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-8963
Mailing Address - Country:US
Mailing Address - Phone:954-344-4488
Mailing Address - Fax:954-344-5195
Practice Address - Street 1:1890 N UNIVERSITY DR
Practice Address - Street 2:SUITE 210
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-8963
Practice Address - Country:US
Practice Address - Phone:954-344-4488
Practice Address - Fax:954-344-5195
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7662122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist