Individual
KELSEY ANN BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1730 NIAGARA FALLS BLVD STE 300, TONAWANDA, NY 14150-7531
(716) 831-2277
Mailing address
1730 NIAGARA FALLS BLVD STE 300, TONAWANDA, NY 14150-7531
(716) 831-2277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
062750
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/18/2021
Last updated
09/12/2022
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