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General NPI Number Information
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NPI Number | 1558347435
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Entity Type | Individual
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Provider Name | PETER BARNDT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | US NAVAL HOSPITAL YOKOSUKA
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City | FPO
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State | AP
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Zip | 96350
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Country | US
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Telephone | 843-228-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 7 MAYWOOD DR
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City | OLD LYME
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State | CT
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Zip | 06371-1544
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Country | US
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Telephone | 843-986-4158
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 5315024593
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License Number State | MI
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