| Ken Berley, D.d.s., Ltd. | |
|
5417 Pinnacle Point Suite 200 Rogers AR 72758-8120 | |
| (479) 254-0200 | |
| (479) 254-0600 |
| Full Name | Ken Berley, D.d.s., Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 5417 Pinnacle Point, Rogers, Arkansas |
| Authorized Official Name and Position | Ken Berley (PRESIDENT,OWNER,DENTIST) |
| Authorized Official Contact | 4792540200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ken Berley, D.d.s., Ltd. 5417 Pinnacle Point Suite 200 Rogers AR 72758-8120 Ph: (479) 254-0200 | Ken Berley, D.d.s., Ltd. 5417 Pinnacle Point Suite 200 Rogers AR 72758-8120 Ph: (479) 254-0200 |
| NPI Number | 1568663821 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 02/26/2013 |
| Medicare PECOS PAC ID | 6002060795 |
|---|---|
| Medicare Enrollment ID | O20130205000235 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568663821 | NPI | - | NPPES |
| 58912 | Other | AR | BLUE CROSS NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2379 (Arkansas) | Primary |
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