Provider Demographics
NPI:1073529707
Name:BARRICKLOW, BRAD D (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:D
Last Name:BARRICKLOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8942 CEDAR BEND RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9391
Mailing Address - Country:US
Mailing Address - Phone:419-829-9921
Mailing Address - Fax:
Practice Address - Street 1:7135 SYLVANIA AVE
Practice Address - Street 2:1-A
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3530
Practice Address - Country:US
Practice Address - Phone:419-885-1115
Practice Address - Fax:419-842-1656
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH206721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice