MEDICARE: DR. BARRY LEE COMER

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	9915	GA

General Provider Information

NPI Number	:	1740491281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARRY LEE COMER

Provider Business Mailing Address
First Line	:	2883 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3924
Country	:	US
Telephone Number	:	404-636-2114
Fax Number	:	404-636-9184

Provider Business Practice Location Address
First Line	:	2883 N DRUID HILLS RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3924
Country	:	US
Telephone Number	:	404-636-2114
Fax Number	:	404-636-9184

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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