Provider Demographics
NPI:1699443432
Name:BERARD, CATHERINE (RDH)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:BERARD
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 MCMILLEN CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1602
Mailing Address - Country:US
Mailing Address - Phone:703-901-6983
Mailing Address - Fax:
Practice Address - Street 1:908 MCMILLEN CT
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-1602
Practice Address - Country:US
Practice Address - Phone:703-901-6983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-04
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402002592124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist