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Organization
G.L. BERRY D.D.S., A DENTAL CORPORATION
Active
Organization
G.L. BERRY D.D.S., A DENTAL CORPORATION
Active
Other names
Neighborhood Family Dental Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLADYS L. BERRY D.D.S. (PRESIDENT)
(858) 362-3540
Entity
Organization
Contact information
Practice address
4655 CASS ST, SUITE 100, SAN DIEGO, CA 92109-2809
(858) 362-3540
(858) 362-3544
Mailing address
4655 CASS ST, SUITE 100, SAN DIEGO, CA 92109-2809
(858) 362-3540
(858) 362-3544
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
39969
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396846036
TYPE 1 NPI NUMBER
CA
01
—
G93297-01
DENTI-CAL
CA
01
—
G98442-01
HEALTHY FAMILIES
CA
Enumeration date
06/20/2007
Last updated
08/13/2007
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