Provider Demographics
NPI:1467547380
Name:BARONE, GARRY J (DDS)
Entity Type:Individual
Prefix:
First Name:GARRY
Middle Name:J
Last Name:BARONE
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 1:2409 L ST
Mailing Address - Street 2:STE 4
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-5025
Mailing Address - Country:US
Mailing Address - Phone:916-443-1905
Mailing Address - Fax:
Practice Address - Street 1:2409 L ST
Practice Address - Street 2:STE 4
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5025
Practice Address - Country:US
Practice Address - Phone:916-443-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA344641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice