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1770195810
PATRICK THOMAS BERG
MANITOWOC, WI
NPI
1770195810
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: WI 1002406-15)
Enumeration Date
2020-08-19
Last Update Date
2020-08-19
Business Address
PATRICK THOMAS BERG DDS
2719 CALUMET AVE
MANITOWOC, WI 54220-5546
Phone number: 920-686-2333
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Mailing Address
PATRICK THOMAS BERG DDS
2463 PORTSIDE LN APT 21
MANITOWOC, WI 54220-9693
Phone number: 414-510-1128
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