Provider Demographics
NPI:1417147901
Name:BARRY, DANIEL D (DMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:BARRY
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 1:3051 HIGHLAND OAKS TERRACE
Mailing Address - Street 2:UNIT #4
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-3004
Mailing Address - Country:US
Mailing Address - Phone:850-656-3917
Mailing Address - Fax:850-942-7120
Practice Address - Street 1:3051 HIGHLAND OAKS TERRACE
Practice Address - Street 2:UNIT #4
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-3004
Practice Address - Country:US
Practice Address - Phone:850-656-3917
Practice Address - Fax:850-942-7120
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00126501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics