Provider Demographics
NPI:1629164181
Name:TUFTS, BARRY CARSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:CARSON
Last Name:TUFTS
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:P.O. BOX 401
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-0401
Mailing Address - Country:US
Mailing Address - Phone:781-383-2218
Mailing Address - Fax:781-383-2217
Practice Address - Street 1:TWELVE PARKINGWAY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025
Practice Address - Country:US
Practice Address - Phone:781-383-2218
Practice Address - Fax:781-383-2217
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
MA155501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice