Provider Demographics
NPI:1699803262
Name:DI BARI, FRANK J (DDS)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:DI BARI
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:PO BOX 466
Mailing Address - Street 2:
Mailing Address - City:REDWAY
Mailing Address - State:CA
Mailing Address - Zip Code:95560-0466
Mailing Address - Country:US
Mailing Address - Phone:707-923-9060
Mailing Address - Fax:707-923-9660
Practice Address - Street 1:76 BRICELAND ROAD
Practice Address - Street 2:
Practice Address - City:REDWAY
Practice Address - State:CA
Practice Address - Zip Code:95560
Practice Address - Country:US
Practice Address - Phone:707-923-9060
Practice Address - Fax:707-923-9660
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice