Provider Demographics
NPI:1710991195
Name:BARBER, PHILIP WILLIAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:WILLIAM
Last Name:BARBER
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 1:30 UNION PARK STREET
Mailing Address - Street 2:#202
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29 FARRAGUT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SOUTH BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02127-1714
Practice Address - Country:US
Practice Address - Phone:617-268-1030
Practice Address - Fax:617-268-2924
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA161131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice