Individual
DR. BRYAN MICHAEL BERGENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
724 S BEACH ST, SUITE 4, DAYTONA BEACH, FL 32114-5441
(386) 258-2213
(386) 253-7943
Mailing address
724 S BEACH ST, SUITE 4, DAYTONA BEACH, FL 32114-5441
(386) 258-2213
(386) 253-7943
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN13806
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487760054
NPI
FL
Enumeration date
05/21/2013
Last updated
05/21/2013
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