Provider Demographics
NPI:1538294418
Name:BARTUSIAK, BARRY F (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:F
Last Name:BARTUSIAK
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 1:212 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9697
Mailing Address - Country:US
Mailing Address - Phone:724-225-3680
Mailing Address - Fax:724-225-4334
Practice Address - Street 1:212 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9697
Practice Address - Country:US
Practice Address - Phone:724-225-3680
Practice Address - Fax:724-225-4334
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026340L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice