Bergin, Dennis G

Bergin, Dennis G is an sole proprietor health care provider with primary practice located at 400 Barrett Pkwy Ste 500 Sears Optical-Town Center Mall, Kennesaw GA 30144-4997. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bergin, Dennis G can be contacted via phone (770) 424-5367.

Contact Information

Primary practice address
400 Barrett Pkwy Ste 500 Sears Optical-Town Center Mall Kennesaw GA 30144-4997
Phone: (770) 424-5367
Fax: (678) 337-7933
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X GA-1071-T Georgia

Profile Details

NPI number 1003876921
LBN Legal business name Bergin, Dennis G
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 24th, 2006
Last updated Feb 16th, 2011 - about 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1003876921 NPPES
Georgia MEDICAID 843143605A

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