Organization
J R BERRY DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R BERRY DDS (PRESIDENT)
(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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103180608
—
AR
Enumeration date
11/19/2009
Last updated
11/19/2009
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