Provider Demographics
NPI:1326170853
Name:BARTHOLOMEW, TERRY L II (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:L
Last Name:BARTHOLOMEW
Suffix:II
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 1:341 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1072
Mailing Address - Country:US
Mailing Address - Phone:419-756-4908
Mailing Address - Fax:419-756-6146
Practice Address - Street 1:341 CLINE AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1072
Practice Address - Country:US
Practice Address - Phone:419-756-4908
Practice Address - Fax:419-756-6146
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH200821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice