Provider Demographics
NPI:1144397225
Name:SPIRO, BARRY L (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:L
Last Name:SPIRO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 CENTRE STREET
Mailing Address - Street 2:
Mailing Address - City:JAMAICL PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130
Mailing Address - Country:US
Mailing Address - Phone:617-524-7860
Mailing Address - Fax:617-524-7861
Practice Address - Street 1:670 CENTRE STREET
Practice Address - Street 2:
Practice Address - City:JAMAICL PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130
Practice Address - Country:US
Practice Address - Phone:617-524-7860
Practice Address - Fax:617-524-7861
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA163741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice