Provider Demographics
NPI:1912276544
Name:BARR, ROBERT E (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:E
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 1:2323 FOREST AVENUE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4609
Mailing Address - Country:US
Mailing Address - Phone:408-247-9626
Mailing Address - Fax:408-247-9683
Practice Address - Street 1:2323 FOREST AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4609
Practice Address - Country:US
Practice Address - Phone:408-247-9626
Practice Address - Fax:408-247-9683
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA234241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice