| Mark D. Berard, Dds, Pc | |
|
203 West 30th Street Holland MI 49423 | |
| (616) 392-2853 | |
| (616) 392-2568 |
| Full Name | Mark D. Berard, Dds, Pc |
|---|---|
| Speciality | Dentist |
| Location | 203 West 30th Street, Holland, Michigan |
| Authorized Official Name and Position | Mark Daniel Berard (DENTIST/OWNER) |
| Authorized Official Contact | 6163922853 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark D. Berard, Dds, Pc 203 West 30th Street Holland MI 49423 Ph: (616) 392-2853 | Mark D. Berard, Dds, Pc 203 West 30th Street Holland MI 49423 Ph: (616) 392-2853 |
| NPI Number | 1942378419 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 02/03/2011 |
| Medicare PECOS PAC ID | 4385745421 |
|---|---|
| Medicare Enrollment ID | O20070719000566 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942378419 | NPI | - | NPPES |
| D145330 | Other | MI | BCBSM |
| 1884295 | Other | UNITED CONCORDIA | |
| D801446 | Other | BCBSM | |
| 625904 | Other | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 02097814533 (Michigan) | Secondary |
| 1223G0001X | Dentist - General Practice | 2901019128 (Michigan) | Primary |
| Provider Name | Mark D Berard |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1942367305 PECOS PAC ID: 7113107103 Enrollment ID: I20110208000780 |
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