Provider Demographics
NPI:1437204880
Name:BARRY, LUCRETIA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LUCRETIA
Middle Name:M
Last Name:BARRY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MILFORD ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-5033
Mailing Address - Country:US
Mailing Address - Phone:516-538-2298
Mailing Address - Fax:
Practice Address - Street 1:186 JORALEMON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4326
Practice Address - Country:US
Practice Address - Phone:718-852-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036402122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist