Individual
DR. JOHN CHESTER BERRY JR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
632 GARY ST, DURHAM, NC 27703-2202
(919) 682-4861
(919) 688-4861
Mailing address
632 GARY ST, DURHAM, NC 27703-2202
(919) 682-4861
(919) 688-4861
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4425
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111150
AETNA PROVIDER NUMBER
NC
05
—
8990679
—
NC
01
—
90679
BLUE CROSS PROVIDER NUMBE
NC
01
—
D402554
CIGNA
NC
Enumeration date
06/15/2006
Last updated
07/09/2007
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