NPI 1023137122

Shane Daniel Bergo, DDSMSD

Practitioner Endodontics Fort Collins, CO

Practice location

Address: 730 Whalers Way Suite 300, Fort Collins, CO 80525-7585
Phone: (970) 229-1404
Fax: (970) 229-1422
Mailing address: 3744 S Timberline Rd Suite 101, Fort Collins, CO 80525-4333

Registered specialties

Endodontics Primary

Dental Providers Taxonomy 1223E0200X Licence 7256 (CO)

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Registry record

NPI: 1023137122
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Mar 2007
Record last updated: 8 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.