NPI 1023677614

Gail Theresa Bergen, DA

Practitioner Dental Assistant San Antonio, TX

Practice location

Address: 427 9th St, San Antonio, TX 78215-1528
Phone: (508) 968-6582

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X Licence DA10457 (MA)

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Registry record

NPI: 1023677614
Entity type: Individual
Sex (as registered): Female
NPI issued: 7 Jun 2019
Record last updated: 7 Jun 2019

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.