Individual
DR. BARRY CARTER STACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
5041 DALLAS HWY, BUILDING 2 SUITE A, POWDER SPRINGS, GA 30127-6458
(770) 429-5507
(770) 429-5525
Mailing address
5041 DALLAS HWY, BUILDING 2 SUITE A, POWDER SPRINGS, GA 30127-6458
(770) 429-5507
(770) 429-5525
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
007936
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN007936
GA STATE LICENSE
GA
Enumeration date
12/18/2006
Last updated
07/08/2007
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