Provider Demographics
NPI:1538378948
Name:BERNSTEIN, DANIEL STUART (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:STUART
Last Name:BERNSTEIN
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 1:301 BAINBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-1543
Mailing Address - Country:US
Mailing Address - Phone:215-925-7330
Mailing Address - Fax:215-925-7331
Practice Address - Street 1:301 BAINBRIDGE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1543
Practice Address - Country:US
Practice Address - Phone:215-925-7330
Practice Address - Fax:215-925-7331
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021766L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist