Provider Demographics
NPI:1134347776
Name:BARRICK, THOMAS G (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:BARRICK
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 1:2432 SOUTH ST.
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074
Mailing Address - Country:US
Mailing Address - Phone:317-896-5143
Mailing Address - Fax:317-896-5861
Practice Address - Street 1:1121 W MICHIGAN STREET
Practice Address - Street 2:DS307B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5186
Practice Address - Country:US
Practice Address - Phone:317-896-5143
Practice Address - Fax:317-896-5861
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN6918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist