Healthcare Provider Details

I. General information

NPI: 1215544184
Provider Name (Legal Business Name): SCOTT BARBER, DDS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4811 BOB BILLINGS PARKWAY SUITE A
LAWRENCE KS
66049
US

IV. Provider business mailing address

4811 BOB BILLINGS PARKWAY SUITE A
LAWRENCE KS
66049
US

V. Phone/Fax

Practice location:
  • Phone: 785-841-2902
  • Fax: 785-841-5312
Mailing address:
  • Phone: 785-841-2902
  • Fax: 785-841-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT BARBER
Title or Position: CEO
Credential: DDS
Phone: 785-841-2902