=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295851418
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DANIEL D. BARRY, D.M.D., M.D.S.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2007
-----------------------------------------------------
Last Update Date | 10/15/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3051 HIGHLAND OAKS TER
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32301-3841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-656-3917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3051 HIGHLAND OAKS TER
-----------------------------------------------------
City | TALLAHASSEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32301-3841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 850-656-3917
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ORTHODONTISTS
-----------------------------------------------------
Name | DR. DANIEL D BARRY
-----------------------------------------------------
Credential | D.M.D., M.D.S.
-----------------------------------------------------
Telephone | 850-656-3917
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 12650
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------