| Malcolm R. Berg, Dmd | |
|
3630 Se Military Dr San Antonio TX 78223-4050 | |
| (210) 337-6834 | |
| Not Available |
| Full Name | Malcolm R. Berg, Dmd |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3630 Se Military Dr, San Antonio, Texas |
| Authorized Official Name and Position | Malcolm R. Berg (DENTIST) |
| Authorized Official Contact | 2103376834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Malcolm R. Berg, Dmd 3601 Leadville Dr Austin TX 78749-6938 Ph: (512) 965-0663 | Malcolm R. Berg, Dmd 3630 Se Military Dr San Antonio TX 78223-4050 Ph: (210) 337-6834 |
| NPI Number | 1841459310 |
|---|---|
| Provider Enumeration Date | 06/09/2008 |
| Last Update Date | 06/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841459310 | NPI | - | NPPES |
| 0094708-03 | Medicaid | TX | |
| 164291001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 17463 (Texas) | Primary |
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