MEDICARE: DR. ROGER P BARRON DDS

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	43316	CA

General Provider Information

NPI Number	:	1861667123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER P BARRON DDS

Provider Business Mailing Address
First Line	:	7668 EL CAMINO REAL
Second Line	:	#104-513
City	:	CARLSBAD
State	:	CA
Zip	:	92009-7932
Country	:	US
Telephone Number	:	858-259-2522
Fax Number	:

Provider Business Practice Location Address
First Line	:	7668 EL CAMINO REAL
Second Line	:	#104-513
City	:	CARLSBAD
State	:	CA
Zip	:	92009-7932
Country	:	US
Telephone Number	:	858-259-2522
Fax Number	:

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

Provider Enumeration Date	:	04/28/2008
Last Update Date	:	04/28/2008

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