Provider Demographics
NPI:1285879429
Name:SEGAL, BARRY S (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:S
Last Name:SEGAL
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 1:3575 NE 207TH ST
Mailing Address - Street 2:SUITE B17
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3771
Mailing Address - Country:US
Mailing Address - Phone:305-933-9911
Mailing Address - Fax:305-933-8068
Practice Address - Street 1:3575 NE 207TH ST
Practice Address - Street 2:SUITE B17
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3771
Practice Address - Country:US
Practice Address - Phone:305-933-9911
Practice Address - Fax:305-933-8068
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN61351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice