Healthcare Provider Details

I. General information

NPI: 1144153495
Provider Name (Legal Business Name): MICHAEL BERGLASS, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 QUANTUM BLVD
BOYNTON BEACH FL
33426-8612
US

IV. Provider business mailing address

2415 QUANTUM BLVD
BOYNTON BEACH FL
33426-8612
US

V. Phone/Fax

Practice location:
  • Phone: 561-736-1700
  • Fax:
Mailing address:
  • Phone: 561-736-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL ELLIS BERGLASS
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 704-254-9500