Provider Demographics
NPI:1548277684
Name:A. GARRETT BERLEY D.D.S.
Entity type:Organization
Organization Name:A. GARRETT BERLEY D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:A
Authorized Official - Middle Name:GARRETT
Authorized Official - Last Name:BERLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-627-5355
Mailing Address - Street 1:1S132 SUMMIT AVE.
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4993
Mailing Address - Country:US
Mailing Address - Phone:630-627-5355
Mailing Address - Fax:630-627-9513
Practice Address - Street 1:1S132 SUMMIT AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3955
Practice Address - Country:US
Practice Address - Phone:630-627-5355
Practice Address - Fax:630-627-9513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty