Provider Demographics
NPI:1972599140
Name:BARRY, ANNE G (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:G
Last Name:BARRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 OLD MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:CENTRAL POINT
Mailing Address - State:OR
Mailing Address - Zip Code:97502-1070
Mailing Address - Country:US
Mailing Address - Phone:541-772-0696
Mailing Address - Fax:
Practice Address - Street 1:906 ROYAL CT
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6139
Practice Address - Country:US
Practice Address - Phone:541-779-2634
Practice Address - Fax:541-779-3282
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice