Individual
ELIZA BERRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
22111 TIMBERLINE WAY, LAKE FOREST, CA 92630-3431
(949) 975-9230
Mailing address
22111 TIMBERLINE WAY, LAKE FOREST, CA 92630-3431
(949) 975-9230
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
101107
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101107
DENTAL
CA
Enumeration date
03/30/2017
Last updated
03/30/2017
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