Provider Demographics
NPI:1538266051
Name:BERKS DENTAL MEDICINE ASSOC PC
Entity type:Organization
Organization Name:BERKS DENTAL MEDICINE ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-370-5955
Mailing Address - Street 1:6 HEARTHSTONE CT
Mailing Address - Street 2:SUITE 304
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-3053
Mailing Address - Country:US
Mailing Address - Phone:610-370-5955
Mailing Address - Fax:610-370-5957
Practice Address - Street 1:6 HEARTHSTONE CT
Practice Address - Street 2:SUITE 304
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-3053
Practice Address - Country:US
Practice Address - Phone:610-370-5955
Practice Address - Fax:610-370-5957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
134820Medicare ID - Type Unspecified