Provider Demographics
NPI:1861667123
Name:BARRON, ROGER P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:P
Last Name:BARRON
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 1:7668 EL CAMINO REAL
Mailing Address - Street 2:#104-513
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-7932
Mailing Address - Country:US
Mailing Address - Phone:858-259-2522
Mailing Address - Fax:
Practice Address - Street 1:7668 EL CAMINO REAL
Practice Address - Street 2:#104-513
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92009-7932
Practice Address - Country:US
Practice Address - Phone:858-259-2522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice