Provider Demographics
NPI:1487066155
Name:BARRY J SLIPOCK DDS APC
Entity type:Organization
Organization Name:BARRY J SLIPOCK DDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SLIPOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-421-5711
Mailing Address - Street 1:750 MEDICAL CENTER CT
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6634
Mailing Address - Country:US
Mailing Address - Phone:619-421-5711
Mailing Address - Fax:619-421-5747
Practice Address - Street 1:750 MEDICAL CENTER CT
Practice Address - Street 2:SUITE 10
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6634
Practice Address - Country:US
Practice Address - Phone:619-421-5711
Practice Address - Fax:619-421-5747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental