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Dr. Shelley Danielle Wade Berganske, DMD
Pediatric Dentist in Suwanee, Georgia
NPI 1922490333

Shelley Danielle Wade Berganske is a Pediatric Dentist based in Suwanee, GA and is specialized in Pediatric Dentistry. Shelley Danielle Wade Berganske practices in Suwanee, GA and has the professional credentials of DMD. The NPI Number for Shelley Danielle Wade Berganske is 1922490333 and holds a License No. DN014966 (Georgia).

The current practice location address for Shelley Danielle Wade Berganske is 1380 Peachtree Industrial Blvd Ste 150, Suwanee, GA and can be reached out via phone at 770-614-8914 and via fax at 770-614-8917.

Location: 1380 Peachtree Industrial Blvd Ste 150, Suwanee, GA, 30024
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922490333
Provider Name
Shelley Danielle Wade Berganske
Credential
DMD
Provider Entity Type
Individual
Gender
Female
Address
1380 Peachtree Industrial Blvd Ste 150, Suwanee, GA, 30024
Phone Number
770-614-8914
Fax Number
770-614-8917
Provider Enumeration Date
02/21/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1380 Peachtree Industrial Blvd Ste 150
City
Suwanee
State
Georgia
Zip
30024-3795
Phone Number
770-614-8914
Fax Number
770-614-8917
person
Provider Business Mailing Address Details
Address
1380 Peachtree Industrial Blvd Ste 150
City
Suwanee
State
Georgia
Zip
30024-3795
Phone Number
770-614-8914
Fax Number
770-614-8917
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DN014966 (Georgia)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
DN014966 (Georgia)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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