Individual
DR. DENNIS WILBERT BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
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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