MEDICARE: DR. BRUCE M BARBASH D.D.S.

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	1223P0700X	Prosthodontics	12707	TX

General Provider Information

NPI Number	:	1780678714
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE M BARBASH D.D.S.

Provider Business Mailing Address
First Line	:	10 MEDICAL PKWY
Second Line	:	SUITE 302
City	:	DALLAS
State	:	TX
Zip	:	75234-7840
Country	:	US
Telephone Number	:	972-241-7917
Fax Number	:	972-241-8562

Provider Business Practice Location Address
First Line	:	10 MEDICAL PKWY
Second Line	:	SUITE 302
City	:	DALLAS
State	:	TX
Zip	:	75234-7840
Country	:	US
Telephone Number	:	972-241-7917
Fax Number	:	972-241-8562

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

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	10/18/2016

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