Bergman, Dennis Wilbert
Bergman, Dennis Wilbert is an individual health care provider with primary practice located at 4041 Barbara Loop Se Suite A, Rio Rancho NM 87124-1065. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Bergman, Dennis Wilbert can be contacted via phone (505) 891-1500.Contact Information
Primary practice address
4041 Barbara Loop Se Suite A
Rio Rancho NM 87124-1065
Phone: (505) 891-1500
Fax: (505) 891-8400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | DD-1948 | New Mexico |
Profile Details
| NPI number | 1356359772 |
|---|---|
| LBN Legal business name | Bergman, Dennis Wilbert |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Jul 9th, 2007 - about 17 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 | 1356359772 | NPPES |
| New Mexico | MEDICAID | 0003299 | |
| New Mexico | Other | 1465519 | |
| New Mexico | MEDICAID | P7216 | |
| New Mexico | Other | NM01810F |
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