Organization
DR RUSSELL BERRY DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R BERRY DDS PA (PRESIDENT DENTIST)
(870) 633-4219
Entity
Organization
Contact information
Practice address
1220 N DIVISION ST, FORREST CITY, AR 72335-2307
(870) 633-4219
(870) 633-4120
Mailing address
1220 N DIVISION ST, FORREST CITY, AR 72335-2307
(870) 633-4219
(870) 633-4120
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2380
AR
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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