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General NPI Number Information
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NPI Number | 1003804279
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Entity Type | Individual
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Provider Name | HARGROW DEXTER BARBER DDS
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Gender | Male
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 100 E LEHIGH AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19125-1000
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Country | US
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Telephone | 215-707-3613
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Fax | 215-707-5405
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Provider Business Mailing Address
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Address Line | 6601 S RURAL RD SOUTHWEST DENTAL GROUP
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City | TEMPE
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State | AZ
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Zip | 85283-3747
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Country | US
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Telephone | 480-456-0821
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS027665L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 22DI020061
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License Number State | NJ
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