Healthcare Provider Details

I. General information

NPI: 1578780326
Provider Name (Legal Business Name): TIMOTHY M. BARBER, DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 EAST NORTH STREET SUITE 412
NEW CASTLE PA
16101-3752
US

IV. Provider business mailing address

125 EAST NORTH STREET SUITE 412
NEW CASTLE PA
16101-3752
US

V. Phone/Fax

Practice location:
  • Phone: 724-498-0491
  • Fax: 724-498-0491
Mailing address:
  • Phone: 724-498-0491
  • Fax: 724-498-0491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS028992L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS028992L
License Number StatePA

VIII. Authorized Official

Name: DR. TIMOTHY MARC BARBER
Title or Position: PRESIDENT
Credential: DMD
Phone: 724-498-0491