Individual
MRS. NICOLE MARIE BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
108 NEW GLENDALE RD, ELIZABETHTOWN, KY 42701-1023
(270) 769-1601
(270) 765-7274
Mailing address
600 EDGEWATER DR, ELIZABETHTOWN, KY 42701-2122
(270) 766-7602
(270) 765-7274
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3995
KY
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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