Organization
BERGMAN FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL E BERGMAN D.D.S. (DENTIST)
(636) 391-9666
Entity
Organization
Contact information
Practice address
15421 CLAYTON RD, SUITE 302, BALLWIN, MO 63011-3161
(636) 391-9666
Mailing address
15421 CLAYTON RD, SUITE 302, BALLWIN, MO 63011-3161
(636) 391-9666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2005018472
MO
Other
Enumeration date
12/20/2010
Last updated
12/20/2010
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