Provider Demographics
NPI:1144225830
Name:BERRY, STEVEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:BERRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N GARLAND AVE
Mailing Address - Street 2:STE A
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-9418
Mailing Address - Country:US
Mailing Address - Phone:972-272-9563
Mailing Address - Fax:972-276-7279
Practice Address - Street 1:1605 N GARLAND AVE
Practice Address - Street 2:STE A
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9418
Practice Address - Country:US
Practice Address - Phone:972-272-9563
Practice Address - Fax:972-276-7279
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice