Provider Demographics
NPI:1336272301
Name:BARNES, WILLIAM TRAVIS (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TRAVIS
Last Name:BARNES
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 1:7319 E 116TH STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038
Mailing Address - Country:US
Mailing Address - Phone:317-842-6944
Mailing Address - Fax:317-842-0297
Practice Address - Street 1:7319 E 116TH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038
Practice Address - Country:US
Practice Address - Phone:317-842-6944
Practice Address - Fax:317-842-0297
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007756122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist