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1487936480
BETHANY ANN BERGSTAD
BROOK PARK, MN
NPI
1487936480
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
124Q00000X Dental Hygienist
(Licence: MN H8918)
Enumeration Date
2011-09-15
Last Update Date
2011-09-15
Business Address
Miss BETHANY ANN BERGSTAD RDH
1619 MALLARD RD
BROOK PARK, MN 55007-4712
Phone number: 218-464-2962
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Mailing Address
Miss BETHANY ANN BERGSTAD RDH
1619 MALLARD RD
BROOK PARK, MN 55007-4712
Phone number: 218-464-2962
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