Organization
BARRY G ACKER DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY G ACKER (PRESIDENT/OWNER)
(903) 597-2848
Entity
Organization
Contact information
Practice address
3100 NEW COPELAND RD, TYLER, TX 75701-7940
(903) 597-2848
(903) 593-9626
Mailing address
3100 NEW COPELAND RD, TYLER, TX 75701-7940
(903) 597-2848
(903) 593-9626
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
8636
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120698902
—
TX
05
—
120698906
—
TX
01
—
4521923
AETNA
TX
01
—
844377
UNITED CONCORDIA
TX
Enumeration date
03/20/2012
Last updated
03/20/2012
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