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General NPI Number Information
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NPI Number | 1285752493
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Entity Type | Organization
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Legal Business Name | RICHARD BARATTA, DDS, PA
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 150 N BANANA RIVER DR
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-2513
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Country | US
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Telephone | 321-459-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 150 N BANANA RIVER DR
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City | MERRITT ISLAND
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State | FL
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Zip | 32952-2513
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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 | RICHARD BARATTA, DDS
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Credential |
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Telephone | 321-459-0400
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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 | 8467
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License Number State | FL
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