Individual
DR. BEROUS LANE PARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
175 E N ST, BENICIA, CA 94510-2728
(707) 745-8264
(707) 745-1959
Mailing address
175 E N ST, BENICIA, CA 94510-2728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
33507
CA
Other
Enumeration date
10/11/2006
Last updated
09/11/2014
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