Provider Demographics
NPI:1053313130
Name:BAARCKE, JOHN M (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:BAARCKE
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:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-0892
Mailing Address - Country:US
Mailing Address - Phone:864-427-9721
Mailing Address - Fax:864-427-9726
Practice Address - Street 1:434 DUNCAN BYPASS
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379
Practice Address - Country:US
Practice Address - Phone:864-427-9721
Practice Address - Fax:864-427-9726
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice