Healthcare Provider Details

I. General information

NPI: 1316985864
Provider Name (Legal Business Name): ALAN M BARNETT BDS ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 CASTOR AVENUE SUITE 302
PHILADELPHIA PA
19152-4026
US

IV. Provider business mailing address

7601 CASTOR AVENUE SUITE 302
PHILADELPHIA PA
19152-4026
US

V. Phone/Fax

Practice location:
  • Phone: 215-422-1414
  • Fax: 215-722-1466
Mailing address:
  • Phone: 215-422-1414
  • Fax: 215-722-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License NumberDS020824L
License Number StatePA

VIII. Authorized Official

Name: DR. ALAN MORRIS BARNETT
Title or Position: OWNER SOLE PROPRIETOR
Credential: BDS
Phone: 215-722-1414