Provider Demographics
NPI:1982860136
Name:BARLOW, JEFF (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFF
Middle Name:
Last Name:BARLOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12240 HESPERIA RD STE C
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-8309
Mailing Address - Country:US
Mailing Address - Phone:760-241-6460
Mailing Address - Fax:760-241-2006
Practice Address - Street 1:12240 HESPERIA RD STE C
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-8309
Practice Address - Country:US
Practice Address - Phone:760-241-6460
Practice Address - Fax:760-241-2006
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA360591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice