Provider Demographics
NPI:1376863035
Name:BARTON, DAVID JAY (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAY
Last Name:BARTON
Suffix:
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 1:100 CHERRYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CROSSETT
Mailing Address - State:AR
Mailing Address - Zip Code:71635-3920
Mailing Address - Country:US
Mailing Address - Phone:870-364-6577
Mailing Address - Fax:870-364-4235
Practice Address - Street 1:100 CHERRYWOOD LN
Practice Address - Street 2:
Practice Address - City:CROSSETT
Practice Address - State:AR
Practice Address - Zip Code:71635-3920
Practice Address - Country:US
Practice Address - Phone:870-364-6577
Practice Address - Fax:870-364-4235
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6051122300000X, 1223G0001X
AR3932122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice