MEDICARE: DANIEL D BARRY DMD

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN0012650	FL

General Provider Information

NPI Number	:	1417147901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL D BARRY DMD

Provider Business Mailing Address
First Line	:	3051 HIGHLAND OAKS TERRACE
Second Line	:	UNIT #4
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-3004
Country	:	US
Telephone Number	:	850-656-3917
Fax Number	:	850-942-7120

Provider Business Practice Location Address
First Line	:	3051 HIGHLAND OAKS TERRACE
Second Line	:	UNIT #4
City	:	TALLAHASSEE
State	:	FL
Zip	:	32301-3004
Country	:	US
Telephone Number	:	850-656-3917
Fax Number	:	850-942-7120

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

Provider Enumeration Date	:	07/31/2007
Last Update Date	:	07/31/2007

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