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NPI 1013234640 · live from the CMS NPI Registry

Allison Bergdoll, DDS, MS

Dentist, Orthodontics and Dentofacial Orthopedics in Fort Wayne, IN. National Provider Identifier 1013234640, active.

NPI record

NPI1013234640 Type 1 · individual
StatusActive
Primary specialtyDentist, Orthodontics and Dentofacial Orthopedics 1223X0400X
Practice location2121 E Dupont Rd, Suite D, Fort Wayne, IN 46825
Practice phone260-490-3554
EnumeratedApril 21, 2010
Last updatedApril 21, 2010
Sole proprietorNo

Taxonomies and licenses

TaxonomyCodeLicense
Dentist, Orthodontics and Dentofacial Orthopedics primary1223X0400X12011061A (IN)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.