Healthcare Provider Details

I. General information

NPI: 1588761183
Provider Name (Legal Business Name): BARRER AND WHITE ORTHODONTISTS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 PENN AVE
WEST READING PA
19611-1128
US

IV. Provider business mailing address

311 PENN AVE
WEST READING PA
19611-1128
US

V. Phone/Fax

Practice location:
  • Phone: 610-376-4288
  • Fax: 610-376-1846
Mailing address:
  • Phone: 610-376-4288
  • Fax: 610-376-1846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS021656L
License Number StatePA

VIII. Authorized Official

Name: DR. JAMES GORDON BARREN
Title or Position: SEC TREAS
Credential: DMD
Phone: 610-376-3956