Provider Demographics
NPI:1770507642
Name:WINBERRY, ALAN W (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:W
Last Name:WINBERRY
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:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:AR
Mailing Address - Zip Code:72576-0010
Mailing Address - Country:US
Mailing Address - Phone:870-895-3609
Mailing Address - Fax:870-895-3606
Practice Address - Street 1:730 HWY 62 W
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:AR
Practice Address - Zip Code:72554
Practice Address - Country:US
Practice Address - Phone:870-895-3609
Practice Address - Fax:870-895-3606
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice