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Organization

HILLARY A BERRY DMD PLLC

Active
Other names
Backcountry Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HILLARY BERRY DMD (OWNER DENTIST)
(425) 409-1655
Entity
Organization

Contact information

Practice address
107 MCKINLEY AVE, KELLOGG, ID 83837-2501
(208) 784-0545
Mailing address
2691 E THOMAS HILL DR, COEUR D ALENE, ID 83815-6335
(425) 409-1655

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
892252493
WA
Enumeration date
09/17/2020
Last updated
09/17/2020
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