MEDICARE: DR. JOSEPH E. BARCLAY D.D.S., P.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	DNC000059	GA

General Provider Information

NPI Number	:	1164571162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH E. BARCLAY D.D.S., P.C

Provider Business Mailing Address
First Line	:	1206B SHERWOOD PARK DR NE
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3445
Country	:	US
Telephone Number	:	770-535-2220
Fax Number	:	770-535-7219

Provider Business Practice Location Address
First Line	:	1206B SHERWOOD PARK DR NE
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3445
Country	:	US
Telephone Number	:	770-535-2220
Fax Number	:	770-535-7219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	07/08/2007

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