Provider Demographics
NPI:1902824303
Name:POLANSKY, BARRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:POLANSKY
Suffix:
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 1:1800 BERLIN RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3736
Mailing Address - Country:US
Mailing Address - Phone:856-795-1121
Mailing Address - Fax:856-216-9879
Practice Address - Street 1:1800 BERLIN RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3736
Practice Address - Country:US
Practice Address - Phone:856-795-1121
Practice Address - Fax:856-216-9879
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice