Kellie Renee Bergendahl, RDH

NPI #1053563619 in Plummer, Idaho

Provider Information

NPI Number
1053563619
Entity Type
Individual
Name
Kellie Renee Bergendahl, RDH
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Dental Hygienist
Credential
RDH
Enumeration Date
Oct 15, 2008
Last Updated
Sep 23, 2019

Practice Location

Address
427 12TH ST
State
Idaho
ZIP Code
83851-4000
Phone
(208) 686-1931

Specialties & Taxonomy Codes

Specialty
Dental Hygienist

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