Provider Demographics
NPI:1831272814
Name:BARR, PHILIP DUANE (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:DUANE
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 1:325 WAYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-4532
Mailing Address - Country:US
Mailing Address - Phone:401-272-2519
Mailing Address - Fax:
Practice Address - Street 1:247 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-2910
Practice Address - Country:US
Practice Address - Phone:401-351-1295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1620122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist