Individual
DENNIS G BERGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
400 BARRETT PKWY STE 500, SEARS OPTICAL-TOWN CENTER MALL, KENNESAW, GA 30144-4997
(770) 424-5367
(678) 337-7933
Mailing address
228 JULIA LYNN LANE, ACWORTH, GA 30102-8184
(770) 424-5367
(678) 337-7933
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
GA-1071-T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
843143605A
—
GA
Enumeration date
03/24/2006
Last updated
02/16/2011
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