Healthcare Provider Details

I. General information

NPI: 1427412691
Provider Name (Legal Business Name): ALAN MORRIS BARNETT BDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2016
Last Update Date: 04/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 CASTOR AVENUE. SUITE #302
PHILADELPHIA PA
19152-4027
US

IV. Provider business mailing address

7601 CASTOR AVENUE; SUITE #302
PHILADELPHIA PA
19152-4027
US

V. Phone/Fax

Practice location:
  • Phone: 215-722-1414
  • Fax: 215-722-1466
Mailing address:
  • Phone: 215-722-1414
  • 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:
Title or Position:
Credential:
Phone: