Provider Demographics
NPI:1942684782
Name:BARWU, BOYEE SR
Entity Type:Individual
Prefix:
First Name:BOYEE
Middle Name:
Last Name:BARWU
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7643 JOLLY LN
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-1221
Mailing Address - Country:US
Mailing Address - Phone:763-762-7927
Mailing Address - Fax:763-270-5473
Practice Address - Street 1:7643 JOLLY LN
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-1221
Practice Address - Country:US
Practice Address - Phone:763-762-7927
Practice Address - Fax:763-270-5473
Is Sole Proprietor?:No
Enumeration Date:2015-07-10
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13595122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist