Bergeson, Lance
Bergeson, Lance is an individual health care provider with primary practice located at 5071 Ne 122Nd Ave , Portland OR 97230-1003. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Bergeson, Lance can be contacted via phone (503) 255-5700.Contact Information
Primary practice address
5071 Ne 122Nd Ave
Portland OR 97230-1003
Phone: (503) 255-5700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | D10462 | Oregon |
| Dental Providers / General Practice | 1223G0001X | DE60647187 | Washington |
Profile Details
| NPI number | 1245683911 |
|---|---|
| LBN Legal business name | Bergeson, Lance |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 19th, 2016 |
| Last updated | Jul 19th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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