Provider Demographics
NPI:1588775084
Name:BARNES, BRUCE W (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:W
Last Name:BARNES
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 1:1424 N HANCOCK AVE STE 2W
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2671
Mailing Address - Country:US
Mailing Address - Phone:719-636-1246
Mailing Address - Fax:719-375-8879
Practice Address - Street 1:1424 N HANCOCK AVE STE 2W
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2671
Practice Address - Country:US
Practice Address - Phone:719-636-1246
Practice Address - Fax:719-375-8879
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO59271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice