Provider Demographics
NPI:1679449458
Name:BERRY SPRINGS DENTAL
Entity type:Organization
Organization Name:BERRY SPRINGS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:404-723-9734
Mailing Address - Street 1:2651 E UNIVERSITY AVE STE 400500
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-3329
Mailing Address - Country:US
Mailing Address - Phone:512-942-7006
Mailing Address - Fax:
Practice Address - Street 1:2651 E UNIVERSITY AVE STE 400500
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-3329
Practice Address - Country:US
Practice Address - Phone:512-942-7006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty