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Individual
DR. MICHELE SHOSHANA BERGEN
Active
Individual
DR. MICHELE SHOSHANA BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D., M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
009275
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
050181
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
042206
CT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
231685
NY
Other
Enumeration date
08/16/2005
Last updated
08/08/2012
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