Provider Demographics
NPI:1831285352
Name:BARRON, EDWARD LEONARD JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:LEONARD
Last Name:BARRON
Suffix:JR
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 1:1730 ROSTRAVER ROAD
Mailing Address - Street 2:P.O. BOX 926
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012
Mailing Address - Country:US
Mailing Address - Phone:724-929-5025
Mailing Address - Fax:724-929-5060
Practice Address - Street 1:1730 ROSTRAVER ROAD
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012
Practice Address - Country:US
Practice Address - Phone:724-929-5025
Practice Address - Fax:724-929-5060
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029087L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice