Healthcare Provider Details

I. General information

NPI: 1033131834
Provider Name (Legal Business Name): DAVID P. BARR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 COUNTY RD. XX
MOSINEE WI
54455
US

IV. Provider business mailing address

1851 COUNTY RD. XX
MOSINEE WI
54455
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-0550
  • Fax: 715-355-5790
Mailing address:
  • Phone: 715-359-0550
  • Fax: 715-355-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0003272015
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3272-015
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: