Provider Demographics
NPI:1497828834
Name:CHAU-BERGLOFF, RUTH B (DMD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:B
Last Name:CHAU-BERGLOFF
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 E. RAY RD.
Mailing Address - Street 2:STE. 7
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225
Mailing Address - Country:US
Mailing Address - Phone:480-792-6880
Mailing Address - Fax:480-792-6870
Practice Address - Street 1:1070 E. RAY RD.
Practice Address - Street 2:STE. 7
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-792-6880
Practice Address - Fax:480-792-6870
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6749122300000X
AZ6749122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist