Individual
STACI BERGERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
4330 BARRANCA PKWY STE 100, IRVINE, CA 92604-4754
(909) 489-0100
Mailing address
4330 BARRANCA PKWY STE 100, IRVINE, CA 92604-4754
(909) 489-0100
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
21911
CA
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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