Individual
DR. KEITH BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
350 HILTON RD, SUITE 201, MYRTLE BEACH, SC 29572-6623
(843) 497-3707
(843) 497-3713
Mailing address
350 HILTON RD, SUITE 201, MYRTLE BEACH, SC 29572-6623
(843) 497-3707
(843) 497-3713
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2698
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX2698
—
SC
Enumeration date
02/14/2006
Last updated
07/08/2007
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