Individual
MARQUES BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 W ST JOHN AVE APT B, NOLANVILLE, TX 76559-4278
(254) 618-7110
Mailing address
402 W ST JOHN AVE APT B, NOLANVILLE, TX 76559-4278
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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