Provider Demographics
NPI:1174262125
Name:BARR, DUSTIN G (DMD)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:G
Last Name:BARR
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 1:300 NW 70TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2384
Mailing Address - Country:US
Mailing Address - Phone:954-327-7400
Mailing Address - Fax:
Practice Address - Street 1:300 NW 70TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2384
Practice Address - Country:US
Practice Address - Phone:954-327-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist