Provider Demographics
NPI:1215922018
Name:BARBER, STEPHEN W (DMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:W
Last Name:BARBER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 CAMPGROUND LN
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:IL
Mailing Address - Zip Code:62899-2264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:232 E 2ND ST
Practice Address - Street 2:
Practice Address - City:FLORA
Practice Address - State:IL
Practice Address - Zip Code:62839-2003
Practice Address - Country:US
Practice Address - Phone:618-662-2167
Practice Address - Fax:618-662-2180
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice