| NPI | 1417971854 |
|---|---|
| Other Name | PENNY BERGLUND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WA 5543) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-08 |