# DOROTHEA J BERRY DDS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUNCOAST ORAL SURGERY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871083709
- **Authorized official:** DR. DOROTHEA BERRY DDS (OMFS)
- **Authorized official phone:** (562) 240-3054

## Contact information

- **Practice address:** 2690 PACIFIC AVE STE 250, LONG BEACH, CA 90806-2663
- **Practice address phone:** (562) 240-3054
- **Practice address fax:** (562) 317-5260
- **Mailing address:** 2690 PACIFIC AVE STE 250, LONG BEACH, CA 90806-2663
- **Mailing address phone:** (562) 240-3054
- **Mailing address fax:** (562) 317-5260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 52968 | CA | Yes |

## Other

- **Enumeration date:** 05/16/2018
- **Last updated:** 05/16/2018