Provider Demographics
NPI:1144232653
Name:BARLEY, MARTIN ALAN (DDS PC MAGD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ALAN
Last Name:BARLEY
Suffix:
Gender:M
Credentials:DDS PC MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2155
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650
Mailing Address - Country:US
Mailing Address - Phone:301-475-0104
Mailing Address - Fax:301-475-3287
Practice Address - Street 1:22650 CEDAR LANE CT
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650
Practice Address - Country:US
Practice Address - Phone:301-475-0104
Practice Address - Fax:301-475-3287
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3364122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist