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General NPI Number Information
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NPI Number | 1447041710
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Entity Type | Individual
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Provider Name | MARCO BERGAMINI DDS
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Gender | Male
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 3302 GASTON AVE STE 732
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City | DALLAS
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State | TX
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Zip | 75246-2013
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Country | US
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Telephone | 214-828-8998
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 MERRIMAC ST
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City | FORT WORTH
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State | TX
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Zip | 76107-2233
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Country | US
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Telephone | 917-291-7658
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 41093
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License Number State | TX
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