| NPI | 1205011293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT T BERGMAN Orthodontist 805-482-7284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: CA D21237) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-01-08 |