Dr Russell Berry DDS PA
Dentist, General Practice in Forrest City, AR. Organization (NPI-2).
NPI number1518079177
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1518079177
- Entity type
- Organization (NPI-2)
- Legal business name
- Dr Russell Berry DDS PA
- Organization subpart
- No
- Enumeration date
- Aug 31, 2006
- Last updated
- Aug 22, 2020
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
Authorized official
John R Berry
President Dentist
8706334219
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