| NPI | 1326362344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL M BERGERON Owner Sole Proprietor 9074-546-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK AA 0819) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2010-03-19 |