Healthcare Provider Details

I. General information

NPI: 1568384188
Provider Name (Legal Business Name): T. BARRY CLOWER, DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1595 MULKEY RD
AUSTELL GA
30106-1111
US

IV. Provider business mailing address

1595 MULKEY RD
AUSTELL GA
30106-1111
US

V. Phone/Fax

Practice location:
  • Phone: 404-453-0122
  • Fax: 770-948-4699
Mailing address:
  • Phone: 404-453-0122
  • Fax: 770-948-4699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LA'TRAVIOUS RUTLEDGE
Title or Position: PRACTICE MANAGER
Credential:
Phone: 404-453-0122