MEDICARE: DR. BARTON B LORRY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS015668L	PA

General Provider Information

NPI Number	:	1013920461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARTON B LORRY DDS

Provider Business Mailing Address
First Line	:	204 TANGLEWOOD DR
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-9545
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 TANGLEWOOD DR
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-9545
Country	:	US
Telephone Number	:	302-644-1611
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2006
Last Update Date	:	07/08/2007

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