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General NPI Number Information
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NPI Number | 1285807271
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Entity Type | Organization
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Legal Business Name | KEVIN R BARRY DDS
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 450 SUTTER ST STE 701
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4206
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Country | US
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Telephone | 415-421-4824
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Fax | 415-421-2765
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Provider Business Mailing Address
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Address Line | 450 SUTTER ST STE 701
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City | SAN FRANCISCO
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State | CA
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Zip | 94108-4206
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Country | US
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Telephone | 415-421-4824
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Fax | 415-421-2765
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN RAYMOND BARRY
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Credential | DDS
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Telephone | 415-421-4824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 37628
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License Number State | CA
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