Individual
ZACKARY DREW BERGESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1050 S PEORIA ST, AURORA, CO 80012-3464
(303) 367-2273
(303) 367-5385
Mailing address
22959 E SMOKY HILL RD, APT A206, AURORA, CO 80015-6702
(215) 439-4307
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19482
MT
1223G0001X
General Practice Dentistry
9128
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09177353
—
CO
Enumeration date
07/23/2006
Last updated
03/25/2021
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