Provider Demographics
NPI:1780733410
Name:SEARS, BARRY D (DMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:D
Last Name:SEARS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 US 31W BYP
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-2316
Mailing Address - Country:US
Mailing Address - Phone:270-781-3311
Mailing Address - Fax:270-842-6465
Practice Address - Street 1:940 US 31W BYP
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-2316
Practice Address - Country:US
Practice Address - Phone:270-781-3311
Practice Address - Fax:270-842-6465
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice