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General NPI Number Information
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NPI Number | 1114009255
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Entity Type | Organization
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Legal Business Name | MICHAEL W. BARBA
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1453 4TH ST SE SUITE A
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City | MASON CITY
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State | IA
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Zip | 50401-4437
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Country | US
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Telephone | 641-423-2172
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Fax | 641-421-4166
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Provider Business Mailing Address
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Address Line | 1453 4TH ST SE SUITE A
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City | MASON CITY
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State | IA
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Zip | 50401-4437
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Country | US
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Telephone | 641-423-2172
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Fax | 641-421-4166
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. MICHAEL WAYNE BARBA
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Credential | D.D.S., M.S.
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Telephone | 641-423-2172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 7089
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License Number State | IA
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