Provider Demographics
NPI:1558565655
Name:BART LEIGH CLEARY
Entity Type:Organization
Organization Name:BART LEIGH CLEARY
Other - Org Name:.BART CLEARY, D.D.S., P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BART
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:CLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-693-7999
Mailing Address - Street 1:912 COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-2645
Mailing Address - Country:US
Mailing Address - Phone:919-693-7999
Mailing Address - Fax:
Practice Address - Street 1:912 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2645
Practice Address - Country:US
Practice Address - Phone:919-693-7999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC48891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1558439885OtherTYPE 1 NPI NUMBER