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Individual

MEAGAN WHITLEY BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RHD

Contact information

Practice address
115 WALNUT ST, ELLINGTON, MO 63638
(573) 663-2313
(573) 663-2322
Mailing address
PO BOX 157, ELLINGTON, MO 63638-0157
(573) 663-2939

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2010018781
MO

Other

Enumeration date
06/24/2010
Last updated
08/04/2011
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