Provider Demographics
NPI:1477756070
Name:BARRY C. SALTZ, DDS, PA
Entity Type:Organization
Organization Name:BARRY C. SALTZ, DDS, PA
Other - Org Name:COMPREHENSIVE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:SALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-797-0541
Mailing Address - Street 1:812 STEVENS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2645
Mailing Address - Country:US
Mailing Address - Phone:207-797-0541
Mailing Address - Fax:
Practice Address - Street 1:812 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2645
Practice Address - Country:US
Practice Address - Phone:207-797-0541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME30401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty