Individual
NEIL E BERGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2660 GRIFFIN AVE, ENUMCLAW, WA 98022-2325
(360) 825-6596
(360) 802-0797
Mailing address
2660 GRIFFIN AVE, ENUMCLAW, WA 98022-2325
(360) 825-6596
(360) 802-0797
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4318
WA
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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