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Individual

DR. MICHEL LAURENTIUS VAN BERGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
450 SUTTER ST, SUITE 1932, SAN FRANCISCO, CA 94108-4206
(415) 986-7655
(415) 986-6967
Mailing address
450 SUTTER ST, SUITE 1932, SAN FRANCISCO, CA 94108-4206
(415) 986-7655
(415) 986-6967

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30874
CA

Other

Enumeration date
10/10/2007
Last updated
10/10/2007
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