Bergstad, Bethany Ann
Bergstad, Bethany Ann is an individual health care provider with primary practice located at 1619 Mallard Rd , Brook Park MN 55007-4712. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Bergstad, Bethany Ann can be contacted via phone (218) 464-2962.Contact Information
Primary practice address
1619 Mallard Rd
Brook Park MN 55007-4712
Phone: (218) 464-2962
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | H8918 | Minnesota |
Profile Details
| NPI number | 1487936480 |
|---|---|
| LBN Legal business name | Bergstad, Bethany Ann |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 15th, 2011 |
| Last updated | Sep 15th, 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.
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