Provider Demographics
NPI:1720197320
Name:BARATZ, BRUCE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:BARATZ
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 1:1765 SPRINGDALE RD
Mailing Address - Street 2:C-2
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2177
Mailing Address - Country:US
Mailing Address - Phone:856-424-0170
Mailing Address - Fax:856-424-7504
Practice Address - Street 1:1765 SPRINGDALE RD
Practice Address - Street 2:C-2
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2177
Practice Address - Country:US
Practice Address - Phone:856-424-0170
Practice Address - Fax:856-424-7504
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI012321001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice