Provider Demographics
NPI:1740490531
Name:BARR, MICHAEL I (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:I
Last Name:BARR
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 1:650 W BOYNTON BEACH BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-3654
Mailing Address - Country:US
Mailing Address - Phone:561-736-2377
Mailing Address - Fax:
Practice Address - Street 1:650 W BOYNTON BEACH BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3654
Practice Address - Country:US
Practice Address - Phone:561-736-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11560122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist