Provider Demographics
NPI:1386857076
Name:BARKER, BRUCE S (DMD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:S
Last Name:BARKER
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 1:7610 FALLS OF NEUSE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3349
Mailing Address - Country:US
Mailing Address - Phone:919-847-7100
Mailing Address - Fax:919-676-3578
Practice Address - Street 1:7610 FALLS OF NEUSE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3349
Practice Address - Country:US
Practice Address - Phone:919-847-7100
Practice Address - Fax:919-676-3578
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC52021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice