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Individual

DR. DAN TERRY BARNES JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
110 SUWANNEE AVE SW, 110 SW SUWANNEE AVENUE, BRANFORD, FL 32008-2749
(386) 935-0988
(386) 935-0989
Mailing address
PO BOX 930, 110 SW SUWANNEE AVENUE, BRANFORD, FL 32008-0930
(386) 935-0988
(386) 935-0989

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN 1040
AK
1223G0001X
General Practice Dentistry
Primary
DN 10874
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
DD 4603
AK
Enumeration date
03/05/2007
Last updated
07/08/2007
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