Provider Demographics
NPI:1548271927
Name:BERNARD, DAVID PETER (DMD MMSC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PETER
Last Name:BERNARD
Suffix:
Gender:M
Credentials:DMD MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FAIRWAY LANE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067
Mailing Address - Country:US
Mailing Address - Phone:781-784-5702
Mailing Address - Fax:
Practice Address - Street 1:10 FAIRWAY LANE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067
Practice Address - Country:US
Practice Address - Phone:781-784-5702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA144341223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics