Provider Demographics
NPI:1053437889
Name:STENFORS-BERGLUND, CARITA (DDS)
Entity type:Individual
Prefix:DR
First Name:CARITA
Middle Name:
Last Name:STENFORS-BERGLUND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CARITA
Other - Middle Name:
Other - Last Name:BERGLUND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:P.O. BOX 500169
Mailing Address - Street 2:SAIPAN ADVENTIST CLINIC
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:US
Mailing Address - Phone:670-234-6008
Mailing Address - Fax:715-845-6493
Practice Address - Street 1:1 QUARTERMASTER ROAD
Practice Address - Street 2:SAIPAN ADVENTIST CLINIC
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-234-6008
Practice Address - Fax:670-234-0521
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5145-015WI1223G0001X
SC89311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice