Organization
DR. BERRY PC
Active
Other names
Koala Center for Sleep Disorders CO1
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN SHAWN BERRY DDS (DOCTOR OF DENTAL SURGERY)
(303) 691-0267
Entity
Organization
Contact information
Practice address
1660 S ALBION ST, SUITE 1008, DENVER, CO 80222-4008
(303) 691-0267
(303) 691-0268
Mailing address
11825 STATE ROUTE 40, SUITE 100, DUNLAP, IL 61525-8842
(309) 839-9941
(309) 839-9943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7991
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003998485
INDIVIDUAL NPI NUMBER
CO
01
—
1962765651
DR. BERRY PC ORGANIZATION (TYPE 2) NPI NUMBER
CO
Enumeration date
03/22/2017
Last updated
03/22/2017
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