Provider Demographics
NPI:1528684560
Name:BARRY, MARIANA PATRICE (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:PATRICE
Last Name:BARRY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JONATHAN CIR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-1767
Mailing Address - Country:US
Mailing Address - Phone:508-560-0275
Mailing Address - Fax:
Practice Address - Street 1:98 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-1472
Practice Address - Country:US
Practice Address - Phone:508-234-5073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-24
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18586721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice