MEDICARE: DR. BENJAMIN DAVID BARRETT

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	1223G0001X	General Practice Dentistry	9219	GA

General Provider Information

NPI Number	:	1750424701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN DAVID BARRETT

Provider Business Mailing Address
First Line	:	56 ALLISON DRIVE
Second Line	:
City	:	CLEVELAND
State	:	GA
Zip	:	30528
Country	:	US
Telephone Number	:	706-219-1825
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 ALLISON DR
Second Line	:
City	:	CLEVELAND
State	:	GA
Zip	:	30528
Country	:	US
Telephone Number	:	706-219-1825
Fax Number	:

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	05/11/2026

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