Bergin, Dennis G
Bergin, Dennis G is an sole proprietor health care provider with primary practice located at 400 Barrett Pkwy Ste 500 Sears Optical-Town Center Mall, Kennesaw GA 30144-4997. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bergin, Dennis G can be contacted via phone (770) 424-5367.Contact Information
Primary practice address
400 Barrett Pkwy Ste 500 Sears Optical-Town Center Mall
Kennesaw GA 30144-4997
Phone: (770) 424-5367
Fax: (678) 337-7933
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | GA-1071-T | Georgia |
Profile Details
| NPI number | 1003876921 |
|---|---|
| LBN Legal business name | Bergin, Dennis G |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 24th, 2006 |
| Last updated | Feb 16th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003876921 | NPPES |
| Georgia | MEDICAID | 843143605A |
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