Individual
DR. DENNIS WILBERT BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4041 BARBARA LOOP SE, SUITE A, RIO RANCHO, NM 87124-1065
(505) 891-1500
(505) 891-8400
Mailing address
13632 CANADA DEL OSO PL NE, ALBUQUERQUE, NM 87111-8030
(505) 298-6684
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DD-1948
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003299
—
NM
01
—
1465519
UNITED CONCORDIA DENTAL
NM
01
—
NM01810F
BLUE CROSS/BLUE SHIELD
NM
05
—
P7216
—
NM
Enumeration date
08/03/2006
Last updated
07/09/2007
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