Provider Demographics
NPI:1679680524
Name:BARR, SCOTT I (DDS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:I
Last Name:BARR
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 1:300 NW 70 AVE
Mailing Address - Street 2:#206
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317
Mailing Address - Country:US
Mailing Address - Phone:954-327-7400
Mailing Address - Fax:954-327-7450
Practice Address - Street 1:300 NW 70 AVE
Practice Address - Street 2:#206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317
Practice Address - Country:US
Practice Address - Phone:954-327-7400
Practice Address - Fax:954-327-7450
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9539122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T94125Medicare UPIN