MEDICARE: BRANDON H BARTON JR DDS PC

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	2901012631	MI

General Provider Information

NPI Number	:	1801214606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANDON H BARTON JR DDS PC

Provider Business Mailing Address
First Line	:	11200 E MCNICHOLS RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48234-3929
Country	:	US
Telephone Number	:	313-521-6400
Fax Number	:	313-521-4710

Provider Business Practice Location Address
First Line	:	11200 E MCNICHOLS RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48234-3929
Country	:	US
Telephone Number	:	313-521-6400
Fax Number	:	313-521-4710

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRANDON HARRIS BARTON JR.
Credential	:
Telephone Number	:	313-521-6400

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	03/31/2014

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