Individual
RONALD LEWIS BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3903 WISEMAN BLVD STE 114, SAN ANTONIO, TX 78251-4401
(210) 256-9467
(210) 256-9468
Mailing address
3903 WISEMAN BLVD STE 114, SAN ANTONIO, TX 78251-4401
(210) 256-9467
(210) 256-9468
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2168-85
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
23704
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN11031
FL
Other
Enumeration date
11/02/2005
Last updated
09/18/2008
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