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General NPI Number Information
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NPI Number | 1679762769
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Entity Type | Individual
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Provider Name | CATHIA BERGERON D.M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | THE UNIVERSITY OF IOWA COLLEGE OF DENTISTRY DEPARTEMENT OF OPERATIVE DENTISTRY, DSB S-229
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City | IOWA CITY
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State | IA
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Zip | 52242-1010
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Country | US
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Telephone | 319-335-6990
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Fax |
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Provider Business Mailing Address
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Address Line | THE UNIVERSITY OF IOWA COLLEGE OF DENTISTRY DEPARTEMENT OF OPERATIVE DENTISTRY, DSB S-229
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City | IOWA CITY
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State | IA
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Zip | 52242-1010
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Country | US
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Telephone | 319-335-6990
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 40104
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License Number State | IA
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