Healthcare Provider Details

I. General information

NPI: 1841280666
Provider Name (Legal Business Name): THOMAS BARLOW DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N FRANKLIN AVE
COLBY KS
67701-2342
US

IV. Provider business mailing address

505 N FRANKLIN AVE
COLBY KS
67701-2342
US

V. Phone/Fax

Practice location:
  • Phone: 785-460-7538
  • Fax:
Mailing address:
  • Phone: 785-460-7538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5575
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: