Provider Demographics
NPI:1780678714
Name:BARBASH, BRUCE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:M
Last Name:BARBASH
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 1:10 MEDICAL PKWY
Mailing Address - Street 2:SUITE 302
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7840
Mailing Address - Country:US
Mailing Address - Phone:972-241-7917
Mailing Address - Fax:972-241-8562
Practice Address - Street 1:10 MEDICAL PKWY
Practice Address - Street 2:SUITE 302
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7840
Practice Address - Country:US
Practice Address - Phone:972-241-7917
Practice Address - Fax:972-241-8562
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127071223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD12707Medicare UPIN
TXD12707Medicare ID - Type UnspecifiedMEDICARE ID NUMBER