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NPI 1801214606

NPI 1801214606 : BRANDON H BARTON JR DDS PC : DETROIT, MI

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General NPI Number Information
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    NPI Number           |    1801214606
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    Entity Type          |    Organization 
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    Legal Business Name  |    BRANDON H BARTON JR DDS PC 
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Dates
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    Enumeration Date     |    03/31/2014
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    Last Update Date     |    03/31/2014
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Provider Practice Location Address
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    Address Line         |    11200 E MCNICHOLS RD 
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48234-3929
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    Country              |    US
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    Telephone            |    313-521-6400
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    Fax                  |    313-521-4710
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Provider Business Mailing Address
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    Address Line         |    11200 E MCNICHOLS RD 
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48234-3929
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    Country              |    US
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    Telephone            |    313-521-6400
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    Fax                  |    313-521-4710
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. BRANDON HARRIS BARTON JR.
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    Credential           |    
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    Telephone            |    313-521-6400
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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       |    2901012631
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    License Number State |    MI
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