Provider Demographics
NPI:1134493539
Name:FOSTER, BARRY CRAIG (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:CRAIG
Last Name:FOSTER
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 1:2705 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:PA
Mailing Address - Zip Code:19403-2227
Mailing Address - Country:US
Mailing Address - Phone:610-666-6585
Mailing Address - Fax:610-666-1357
Practice Address - Street 1:2705 EGYPT RD
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:PA
Practice Address - Zip Code:19403-2227
Practice Address - Country:US
Practice Address - Phone:610-666-6585
Practice Address - Fax:610-666-1357
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027842L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist