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General NPI Number Information
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NPI Number | 1164501508
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Entity Type | Organization
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Legal Business Name | JOHN P BARLOW DDS PC
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 204 W MAPLE ST
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City | CHEROKEE
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State | IA
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Zip | 51012-1853
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Country | US
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Telephone | 712-225-4211
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Fax |
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Provider Business Mailing Address
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Address Line | 204 W MAPLE ST
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City | CHEROKEE
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State | IA
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Zip | 51012-1853
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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 | PRESIDENT
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Name | JOHN P BARLOW
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Credential |
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Telephone | 712-225-4211
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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 | 05291
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License Number State | IA
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