Individual
MATTHEW BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8154 E FLORENTINE RD STE B, PRESCOTT VALLEY, AZ 86314-8487
(928) 772-8175
Mailing address
8154 E FLORENTINE RD STE B, PRESCOTT VALLEY, AZ 86314-8487
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D5843
AZ
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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