Provider Demographics
NPI:1053723817
Name:BERGER, FARYN (DDS)
Entity type:Individual
Prefix:DR
First Name:FARYN
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 KNEELAND STREET
Mailing Address - Street 2:TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-636-2163
Mailing Address - Fax:617-636-3888
Practice Address - Street 1:1 KNEELAND STREET
Practice Address - Street 2:TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-636-2163
Practice Address - Fax:617-636-3888
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program