Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 6085 | MD |
NPI | 1003039561 |
---|---|
Provider Name | Dr. Bruce Stephen Barr |
First Address | Pikesville, MD 21208 |
Second Address | Pikesville, MD 21208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |