Provider Demographics
NPI:1689670713
Name:BARWICK, IAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:
Last Name:BARWICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 LAKEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3414
Mailing Address - Country:US
Mailing Address - Phone:978-957-5511
Mailing Address - Fax:978-957-6419
Practice Address - Street 1:1345 LAKEVIEW AVE
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-3414
Practice Address - Country:US
Practice Address - Phone:978-957-5511
Practice Address - Fax:978-957-6419
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MA142501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies