Individual
DR. TIMOTHY MICHAEL BARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
411 NICHOLS RD, SUITE 241, KANSAS CITY, MO 64112-2000
(816) 561-2800
(816) 561-4574
Mailing address
411 NICHOLS RD, SUITE 241, KANSAS CITY, MO 64112-2000
(816) 561-2800
(816) 561-4574
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13294
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08375015
BLUE CROSS BLUE SHIELD
MO
05
—
TMB9291953
—
MO
Enumeration date
06/19/2006
Last updated
10/18/2010
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