Provider Demographics
NPI:1689792848
Name:SCHOLL, BARRY STEPHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:STEPHEN
Last Name:SCHOLL
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 1:815 NW 57TH AVE
Mailing Address - Street 2:SUITE344
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2018
Mailing Address - Country:US
Mailing Address - Phone:305-264-2711
Mailing Address - Fax:
Practice Address - Street 1:815 NW 57TH AVE
Practice Address - Street 2:SUITE344
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2018
Practice Address - Country:US
Practice Address - Phone:305-264-2711
Practice Address - Fax:305-264-2235
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN50621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice