Individual
ALEXA BERGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
4175 S ALAMO AVE, DAVIS-MONTHAN AFB, AZ 85707
(520) 228-2650
Mailing address
4175 S ALAMO AVE, DAVIS-MONTHAN AFB, AZ 85707
(520) 228-1506
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
61602
KS
1223G0001X
General Practice Dentistry
Primary
019034290
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2019
Last updated
07/20/2026
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