Provider Demographics
NPI:1033160486
Name:DAROCHA, BARRY F (DMD, MAGD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:F
Last Name:DAROCHA
Suffix:
Gender:M
Credentials:DMD, MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N KESWICK AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-4804
Mailing Address - Country:US
Mailing Address - Phone:215-885-4252
Mailing Address - Fax:215-885-7487
Practice Address - Street 1:230 N KESWICK AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-4804
Practice Address - Country:US
Practice Address - Phone:215-885-4252
Practice Address - Fax:215-885-7487
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS2341701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice