| NPI | 1780790881 |
|---|---|
| Former Legal Business Name | AXEL BERGSTEDT AND JOHNSON PA |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M BERGSTEADT Owner Dentist 952-938-8533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 8734) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 10769) |
| 122300000X Dentist (Licence: MN 11571) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2008-07-16 |