Provider Demographics
NPI:1679650139
Name:LATINA, BARBARA (DMD)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:LATINA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 SUMMERHILL RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4911
Mailing Address - Country:US
Mailing Address - Phone:732-257-5444
Mailing Address - Fax:732-257-7687
Practice Address - Street 1:172 SUMMERHILL RD
Practice Address - Street 2:SUITE 6
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4911
Practice Address - Country:US
Practice Address - Phone:732-257-5444
Practice Address - Fax:732-257-7687
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ158421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice