Provider Demographics
NPI:1912641747
Name:WINBERRY, DEBORAH WRATHER (RDH)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:WRATHER
Last Name:WINBERRY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 HALL RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38019-7371
Mailing Address - Country:US
Mailing Address - Phone:901-233-0542
Mailing Address - Fax:
Practice Address - Street 1:1003 S COLLEGE ST
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:TN
Practice Address - Zip Code:38019-3109
Practice Address - Country:US
Practice Address - Phone:901-475-0805
Practice Address - Fax:901-475-4068
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2699124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist