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2600 James Road Ste #100 Granbury TX 76049 | |
| (817) 326-4098 | |
| (817) 326-4470 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2600 James Road, Granbury, Texas |
| Authorized Official Name and Position | Jason Albert Berry (DENTIST) |
| Authorized Official Contact | 8173264098 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2600 James Road Ste #100 Granbury TX 76049 Ph: (817) 326-4098 | 2600 James Road Ste #100 Granbury TX 76049 Ph: (817) 326-4098 |
| NPI Number | 1093843179 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093843179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19777 (Texas) | Secondary |
| 1223G0001X | Dentist - General Practice | 19354 (Texas) | Primary |
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