Provider Demographics
NPI:1922317791
Name:BRUCE BARBASH, DDS, PC
Entity Type:Organization
Organization Name:BRUCE BARBASH, DDS, PC
Other - Org Name:CENTER FOR DENTAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARBASH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-241-7917
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-28
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127071223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD12707Medicare UPIN