Provider Demographics
NPI:1073789194
Name:BARCLAY, PAULA S (RDH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:BARCLAY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 MAIN ST
Mailing Address - Street 2:104E
Mailing Address - City:EDWARDS
Mailing Address - State:CO
Mailing Address - Zip Code:81632-8109
Mailing Address - Country:US
Mailing Address - Phone:970-926-4321
Mailing Address - Fax:
Practice Address - Street 1:27 MAIN ST
Practice Address - Street 2:104E
Practice Address - City:EDWARDS
Practice Address - State:CO
Practice Address - Zip Code:81632-8109
Practice Address - Country:US
Practice Address - Phone:970-926-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO903667124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist