DR. MICHELE SHOSHANA BERGEN D.M.D., M.D.

Surgery Yellow Pages

Greenwich, Connecticut

Provider NPI: 1215929286

Provider Information:
DR. MICHELE SHOSHANA BERGEN D.M.D., M.D.


Practice Location:
49 LAKE AVE  GREENWICH, CT 06830 US
Tel: 203-661-4231  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	1223S0112X	Dental Providers Dentist Oral and Maxillofacial Surgery	NY	050181
N	204E00000X	Physicians Oral & Maxillofacial Surgery	NY	231685
Y	1223S0112X	Dental Providers Dentist	CT	009275
N	204E00000X	Physicians Oral & Maxillofacial Surgery	CT	042206

Other Provider Identifiers:

Issuer	Number	State	Type
	001422063	CT	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin