Provider Demographics
NPI:1972834570
Name:BAN R BARBAT, DDS-PC
Entity Type:Organization
Organization Name:BAN R BARBAT, DDS-PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:F
Authorized Official - Last Name:DINDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-739-2155
Mailing Address - Street 1:6044 24 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-3201
Mailing Address - Country:US
Mailing Address - Phone:586-739-2155
Mailing Address - Fax:248-282-0378
Practice Address - Street 1:6044 24 MILE RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-3201
Practice Address - Country:US
Practice Address - Phone:586-739-2155
Practice Address - Fax:248-282-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901016308122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty