Provider Demographics
NPI:1912048257
Name:SHAMUS, BARRY HERBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:HERBERT
Last Name:SHAMUS
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 1:840 MAIN ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054
Mailing Address - Country:US
Mailing Address - Phone:508-376-8996
Mailing Address - Fax:
Practice Address - Street 1:840 MAIN ST
Practice Address - Street 2:SUITE 112
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054
Practice Address - Country:US
Practice Address - Phone:508-376-8996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11695122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist