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General NPI Number Information
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NPI Number | 1518129584
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Entity Type | Individual
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Provider Name | MICHAEL JAY BARLOW D.D.S
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Gender | Male
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 01/05/2009
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Provider Practice Location Address
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Address Line | 2400 ST. MARYS RD. SUITE A
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City | ST. MARYS
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State | GA
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Zip | 31558
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Country | US
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Telephone | 912-576-2677
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Fax |
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Provider Business Mailing Address
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Address Line | 2400 ST. MARYS RD. SUITE A
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City | ST. MARYS
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State | GA
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Zip | 31558
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Country | US
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Telephone | 912-576-2677
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN013683
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License Number State | GA
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