MEDICARE: DR. MELVIN LEE BARBER 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	1223G0001X	General Practice Dentistry	DS020068L	PA

General Provider Information

NPI Number	:	1104840149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN LEE BARBER DDS

Provider Business Mailing Address
First Line	:	518 N DIVISION ST
Second Line	:	PO BOX 158
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1713
Country	:	US
Telephone Number	:	814-542-4461
Fax Number	:	814-542-4040

Provider Business Practice Location Address
First Line	:	518 N DIVISION ST
Second Line	:
City	:	MOUNT UNION
State	:	PA
Zip	:	17066-1713
Country	:	US
Telephone Number	:	814-542-4461
Fax Number	:	814-542-4040

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	07/08/2007

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