Individual
DR. BARRY WYLLYS FENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
505 LAKE ST, GRAYLING, MI 49738-1263
(989) 348-5923
Mailing address
505 FRED BEAR DR, P.O. BOX 505, GRAYLING, MI 49738
(989) 348-5923
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901012065
MI
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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