Provider Demographics
NPI:1891853164
Name:BARTA, JOHN F (DMD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:F
Last Name:BARTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:F
Other - Last Name:BARTA DMD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:57 NORTH ST
Mailing Address - Street 2:SUITE 221
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:203-791-2710
Mailing Address - Fax:203-791-2710
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE 221
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:203-791-2710
Practice Address - Fax:203-791-2710
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT83881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice