Individual
MS. CONSTANCE VAN DORP BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDHAP
Contact information
Practice address
199 PACIFIC VIEW LN, ENCINITAS, CA 92024-7725
(909) 568-8071
Mailing address
1540 W FLOWER CIR N, PHOENIX, AZ 85015-5836
(909) 568-8071
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
239
CA
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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