Provider Demographics
NPI:1083787592
Name:ELDON G BARROWES DDS & ASSOC PC
Entity Type:Organization
Organization Name:ELDON G BARROWES DDS & ASSOC PC
Other - Org Name:ELDON BARROWES DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELDON
Authorized Official - Middle Name:G
Authorized Official - Last Name:BARROWES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:217-479-0900
Mailing Address - Street 1:1515 WEST WALNUT
Mailing Address - Street 2:BLDG #3
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650
Mailing Address - Country:US
Mailing Address - Phone:217-479-0900
Mailing Address - Fax:217-479-0990
Practice Address - Street 1:1515 WEST WALNUT
Practice Address - Street 2:BLDG #3
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650
Practice Address - Country:US
Practice Address - Phone:217-479-0900
Practice Address - Fax:217-479-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty