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General NPI Number Information
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NPI Number | 1174882955
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Entity Type | Individual
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Provider Name | PHILLIP CHARLES BARRAS DMD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 374 MEDICAL GROUP UNIT 5071
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City | APO
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State | AP
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Zip | 96328
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Country | US
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Telephone | 314-225-3671
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Fax |
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Provider Business Mailing Address
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Address Line | 52 MDG UNIT 3690
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City | APO
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State | AE
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Zip | 09126
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 019.029068
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.029068
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License Number State | IL
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