Organization
ADVANTAGE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC L. BERRY DDS (OWNER)
(719) 545-1400
Entity
Organization
Contact information
Practice address
1800 FORTINO BLVD UNIT 1, PUEBLO, CO 81008-1891
(719) 545-1400
(719) 545-5153
Mailing address
1800 FORTINO BLVD UNIT 1, PUEBLO, CO 81008-1891
(719) 545-1400
(719) 545-5153
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
105682
CO
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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