Healthcare Provider Details

I. General information

NPI: 1881853240
Provider Name (Legal Business Name): MARK ANTHONY BARR D.D.S., P.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 PEACHTREE RD NW SUITE 420
ATLANTA GA
30305-2192
US

IV. Provider business mailing address

2970 PEACHTREE RD NW SUITE 420
ATLANTA GA
30305-2192
US

V. Phone/Fax

Practice location:
  • Phone: 404-264-1944
  • Fax: 404-264-1164
Mailing address:
  • Phone: 404-264-1944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDN011353
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: