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Organization

CEDAR LODGE DENTAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID L BERRY D.D.S. (PRESIDENT)
(785) 625-7369
Entity
Organization

Contact information

Practice address
1001 CODY AVE, HAYS, KS 67601-2430
(785) 625-7369
(785) 625-7667
Mailing address
1001 CODY AVE, HAYS, KS 67601-2430
(785) 625-7369
(785) 625-7667

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5950
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59703
BCBS KS INSURANCE
KS
01
835408
UNITED CONCORDIA DENTAL
PA
Enumeration date
09/20/2006
Last updated
08/22/2020
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