Provider Demographics
NPI:1306905989
Name:BARTH, TOM L (DDS)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:L
Last Name:BARTH
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1133 COLLEGE AVE
Mailing Address - Street 2:BLDG. D LOWER LEVEL
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2770
Mailing Address - Country:US
Mailing Address - Phone:785-776-7242
Mailing Address - Fax:785-776-5862
Practice Address - Street 1:1133 COLLEGE AVE
Practice Address - Street 2:BLDG. D LOWER LEVEL
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2770
Practice Address - Country:US
Practice Address - Phone:785-776-7242
Practice Address - Fax:785-776-5862
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS53331223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS741270OtherUNCON