John Russell Berry, D.D.S.
Dentist, General Practice in Forrest City, AR. Individual provider (NPI-1).
NPI number1255662680
StatusActive
Last updated in NPPESJan 25, 2010
Details
- NPI
- 1255662680
- Entity type
- Individual (NPI-1)
- Name
- Mr. John Russell Berry
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 25, 2010
- Last updated
- Jan 25, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 2380 | AR | Yes |
Practice location
1220 N Division StForrest City, AR 72335-2307
Phone 870-633-4219 · Fax 870-633-4120
Mailing address
1220 N Division StForrest City, AR 72335-2307
Phone 870-633-4219 · Fax 870-633-4120
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