Provider Demographics
NPI:1003039561
Name:BARR, BRUCE STEPHEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:STEPHEN
Last Name:BARR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1864C REISTERSTOWN ROAD
Mailing Address - Street 2:WOODHOUSE SQUARE CENTER
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-484-4140
Mailing Address - Fax:410-484-5636
Practice Address - Street 1:1864C REISTERSTOWN ROAD
Practice Address - Street 2:WOODHOUSE SQUARE CENTER
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:410-484-4140
Practice Address - Fax:410-484-5636
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6085122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist