Provider Demographics
NPI:1417542481
Name:BARTH, DEAN MARTIN
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:MARTIN
Last Name:BARTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 FOWLER ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-7909
Mailing Address - Country:US
Mailing Address - Phone:580-231-7663
Mailing Address - Fax:
Practice Address - Street 1:1601 FOWLER ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-7909
Practice Address - Country:US
Practice Address - Phone:580-231-7663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist