Provider Demographics
NPI:1669481297
Name:SLIPOCK, BARRY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:J
Last Name:SLIPOCK
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 1:750 MEDICAL CENTER CT
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6634
Mailing Address - Country:US
Mailing Address - Phone:619-421-5711
Mailing Address - Fax:619-421-5747
Practice Address - Street 1:750 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 10
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6634
Practice Address - Country:US
Practice Address - Phone:619-421-5711
Practice Address - Fax:619-421-5747
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA216481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice