Provider Demographics
NPI:1043698723
Name:ROBERT G BARHAM DMD, PC
Entity Type:Organization
Organization Name:ROBERT G BARHAM DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-878-8804
Mailing Address - Street 1:215 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-2261
Mailing Address - Country:US
Mailing Address - Phone:256-878-8804
Mailing Address - Fax:877-765-6643
Practice Address - Street 1:215 S BROAD ST
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2261
Practice Address - Country:US
Practice Address - Phone:256-878-8804
Practice Address - Fax:877-765-6643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL42141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty