Provider Demographics
NPI:1376821694
Name:PAUL E BARLOW D.D.S.
Entity Type:Organization
Organization Name:PAUL E BARLOW D.D.S.
Other - Org Name:BARLOW FAMILY DENISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR. BARLOW DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-268-5200
Mailing Address - Street 1:586 W 5300 SOUTH
Mailing Address - Street 2:SUITE #102
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84123
Mailing Address - Country:US
Mailing Address - Phone:801-268-5200
Mailing Address - Fax:801-261-5286
Practice Address - Street 1:586 W 5300 SOUTH
Practice Address - Street 2:SUITE #102
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84123
Practice Address - Country:US
Practice Address - Phone:801-268-5200
Practice Address - Fax:801-261-5286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1450601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT145060OtherSTATE LIENCE #
UT841424167OtherT.I.N
UT1891907846OtherNPI TYPE 1