Provider Demographics
NPI:1134279789
Name:BRETT BARBER DDS PC
Entity Type:Organization
Organization Name:BRETT BARBER DDS PC
Other - Org Name:BARBER FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-516-8338
Mailing Address - Street 1:2615 THREE OAKS RD.
Mailing Address - Street 2:SUITE 2-D
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013
Mailing Address - Country:US
Mailing Address - Phone:847-516-8338
Mailing Address - Fax:847-516-3405
Practice Address - Street 1:2615 THREE OAKS RD.
Practice Address - Street 2:SUITE 2-D
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013
Practice Address - Country:US
Practice Address - Phone:847-516-8338
Practice Address - Fax:847-516-3405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty