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Individual

DR. CHAD CORY BANGERTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
DENTAC BAVARIA CMR 411, APO, NY 09112-8053
(910) 723-1119
Mailing address
CMR 411 BOX 4542, APO, AE 09112-0046

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
5368603-9921
UT
1223E0200X
Endodontics
Primary
5368303-9921
UT

Other

Enumeration date
06/14/2006
Last updated
06/26/2023
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