Provider Demographics
NPI:1205845195
Name:BERRYHILL, RICHARD BRADLEY (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BRADLEY
Last Name:BERRYHILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 HILDERBRAND DR NE
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3906
Mailing Address - Country:US
Mailing Address - Phone:404-255-2273
Mailing Address - Fax:
Practice Address - Street 1:290 HILDERBRAND DR NE
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3906
Practice Address - Country:US
Practice Address - Phone:404-255-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013233122300000X
TNDS8240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist