Individual
TANNER BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5350 S ROBERT TRL, INVER GROVE HEIGHTS, MN 55077-1404
(651) 450-9579
Mailing address
2200 COUNTY ROAD C W STE 2210, ROSEVILLE, MN 55113-2551
(651) 746-2815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D14444
MN
1223G0001X
General Practice Dentistry
Primary
D14444
MN
Other
Enumeration date
07/20/2020
Last updated
07/20/2020
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