Healthcare Provider Details
I. General information
NPI: 1194267724
Provider Name (Legal Business Name): JAMES H BARTON MD DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/14/2016
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
882 N MAIN ST
RICHFIELD UT
84701-1840
US
IV. Provider business mailing address
882 N MAIN ST
RICHFIELD UT
84701-1840
US
V. Phone/Fax
- Phone: 435-287-4455
- Fax: 435-287-0522
- Phone: 435-287-4455
- Fax: 435-287-0522
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | 95126489924 |
| License Number State | UT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | 95126481205 |
| License Number State | UT |
VIII. Authorized Official
Name: DR.
JAMES
HAYNIE
BARTON
Title or Position: PRESIDENT
Credential: MD, DDS
Phone: 435-287-4455