Organization
ROBERT T. BERGMAN, DDS, MS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T BERGMAN D.D.S. (ORTHODONTIST)
(805) 482-7284
Entity
Organization
Contact information
Practice address
400 MOBIL AVE, C-1, CAMARILLO, CA 93010-6338
(805) 482-7284
(805) 482-5196
Mailing address
400 MOBIL AVE, C-1, CAMARILLO, CA 93010-6338
(805) 482-7284
(805) 482-5196
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D21237
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B21237-01
MED-CAL PROVIDER
CA
Enumeration date
01/08/2008
Last updated
01/08/2008
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