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General NPI Number Information
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NPI Number | 1053660837
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Entity Type | Individual
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Provider Name | BARRY DENNY
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Gender | Male
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 1335 BRIDGEPORT DR
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City | KERNERSVILLE
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State | NC
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Zip | 27284-3733
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Country | US
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Telephone | 336-992-9090
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Fax | 336-992-9093
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Provider Business Mailing Address
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Address Line | 1335 BRIDGEPORT DR
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City | KERNERSVILLE
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State | NC
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Zip | 27284-3733
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Country | US
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Telephone |
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 92795
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License Number State | NC
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