Provider Demographics
NPI:1104939883
Name:PAIGE, BARRY A (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:A
Last Name:PAIGE
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 1:119 W 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:KS
Mailing Address - Zip Code:67548-9603
Mailing Address - Country:US
Mailing Address - Phone:785-222-2527
Mailing Address - Fax:
Practice Address - Street 1:119 W 8TH ST
Practice Address - Street 2:
Practice Address - City:LACROSSE
Practice Address - State:KS
Practice Address - Zip Code:67548-0306
Practice Address - Country:US
Practice Address - Phone:785-222-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS54691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice