Organization
KEN BERLEY, D.D.S., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEN BERLEY DDS (PRESIDENT,OWNER,DENTIST)
(479) 254-0200
Entity
Organization
Contact information
Practice address
5417 PINNACLE POINT, SUITE 200, ROGERS, AR 72758-8120
(479) 254-0200
(479) 254-0600
Mailing address
5417 PINNACLE POINT, SUITE 200, ROGERS, AR 72758-8120
(479) 254-0200
(479) 254-0600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2379
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58912
BLUE CROSS NUMBER
AR
Enumeration date
05/31/2007
Last updated
02/26/2013
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