Provider Demographics
NPI:1639306970
Name:BARBONE, NORMAN KEITH (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:KEITH
Last Name:BARBONE
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 1:391 GLESSNER AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44903-2153
Mailing Address - Country:US
Mailing Address - Phone:419-522-2821
Mailing Address - Fax:419-522-1031
Practice Address - Street 1:391 GLESSNER AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2153
Practice Address - Country:US
Practice Address - Phone:419-522-2821
Practice Address - Fax:419-522-1031
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-13
Last Update Date:2009-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.17472122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist