Individual
JOSEPHINE BERGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
BOX 81 618TH DENTAL CO. (AS), UNIT 15652, APO AP, CA 96205-5652
(010) 394-1653
Mailing address
618TH DENTAL CO (AS), UNIT 15652, APO, AP 96205-5652
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/19/2016
Last updated
07/19/2016
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