Individual
DR. ERIC P BERGQUAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
906 DEBORAH RD, NEWBERG, OR 97132
(503) 538-5476
(503) 538-8293
Mailing address
906 DEBORAH RD, NEWBERG, OR 97132
(503) 538-5476
(503) 538-8293
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8310
OR
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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