MEDICARE: DR. BARBARA BISANG KING D.D.S.

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	1223P0700X	Prosthodontics	0401008160	VA

General Provider Information

NPI Number	:	1346242369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA BISANG KING D.D.S.

Provider Business Mailing Address
First Line	:	PSC 80
Second Line	:	BOX 6
City	:	APO
State	:	AP
Zip	:	96367-9998
Country	:	US
Telephone Number	:	703-863-7975
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 MDG
Second Line	:	UNIT 5142
City	:	APO
State	:	AP
Zip	:	96368-5142
Country	:	US
Telephone Number	:	315-630-4806
Fax Number	:

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2010

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