Provider Demographics
NPI:1063562015
Name:BARBER, BRETT ANTHONY (DDS)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:ANTHONY
Last Name:BARBER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9245 SUGAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-9013
Mailing Address - Country:US
Mailing Address - Phone:847-899-6636
Mailing Address - Fax:
Practice Address - Street 1:1233 63RD ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-1943
Practice Address - Country:US
Practice Address - Phone:515-277-6358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190229631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice