Provider Demographics
NPI:1326115601
Name:HIBBETT, BARRY KENNETH JR (DMD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:KENNETH
Last Name:HIBBETT
Suffix:JR
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 1:405 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-766-4236
Mailing Address - Fax:256-766-4328
Practice Address - Street 1:405 N CEDAR ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-766-4236
Practice Address - Fax:256-766-4328
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist