| NPI | 1801819826 |
|---|---|
| Doing Business As | BERGSTROM EYE AND LASER CLINIC |
| Entity Type | Organization |
| Authorized Contact | LANCE BERGSTROM Owner 701-235-5200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: ND 7230) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: ND 545) |
| 152W00000X Optometrist (Licence: MN 2581) | |
| 174400000X Specialist (Licence: MN 38105) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2010-07-22 |