Provider Demographics
NPI:1679695647
Name:BARTON, ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:BARTON
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 1:916 WEST ST
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-2037
Mailing Address - Country:US
Mailing Address - Phone:707-762-5301
Mailing Address - Fax:707-763-6721
Practice Address - Street 1:216 HOWARD ST
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-2719
Practice Address - Country:US
Practice Address - Phone:707-763-8088
Practice Address - Fax:707-763-6721
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice