Individual
EMILY WAUNEKA BERG IKAHIHIFO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
(505) 368-6360
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-6360
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD3670
NM
1223E0200X
Endodontics
7098
OK
1223E0200X
Endodontics
Primary
DD3670
NM
1223G0001X
General Practice Dentistry
DD3670
NM
Other
Enumeration date
08/13/2012
Last updated
07/20/2022
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