Provider Demographics
NPI:1336106236
Name:BARBER, CHARLES L (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:BARBER
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 1:5500 STEUBENVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1401
Mailing Address - Country:US
Mailing Address - Phone:412-788-1911
Mailing Address - Fax:412-788-1911
Practice Address - Street 1:5500 STEUBENVILLE PIKE
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1401
Practice Address - Country:US
Practice Address - Phone:412-788-1911
Practice Address - Fax:412-788-1911
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS25667L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA923752OtherUNITED CONCORDIA COMPANIE