Provider Demographics
NPI:1992844138
Name:MERCER, BARRY N (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:N
Last Name:MERCER
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:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-0005
Mailing Address - Country:US
Mailing Address - Phone:916-652-5424
Mailing Address - Fax:916-652-8945
Practice Address - Street 1:3475 TAYLOR RD.
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-0005
Practice Address - Country:US
Practice Address - Phone:916-652-5424
Practice Address - Fax:916-652-8945
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice