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General NPI Number Information
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NPI Number | 1194836882
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Entity Type | Individual
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Provider Name | MARYA BARNES D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1919 7TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35294-0001
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Country | US
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Telephone | 205-934-4551
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Fax | 205-934-7901
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Provider Business Mailing Address
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Address Line | 211 LOUDON HILL DR
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City | WARNER ROBINS
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State | GA
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Zip | 31088-8531
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 4993
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License Number State | AL
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