Provider Demographics
NPI:1902927742
Name:BARRY KENT MACH, DDS PA
Entity Type:Organization
Organization Name:BARRY KENT MACH, DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:MACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-461-0999
Mailing Address - Street 1:1861 BROWN BLVD
Mailing Address - Street 2:STE 225
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-4697
Mailing Address - Country:US
Mailing Address - Phone:817-461-0999
Mailing Address - Fax:817-801-3121
Practice Address - Street 1:1861 BROWN BLVD
Practice Address - Street 2:STE 225
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-4697
Practice Address - Country:US
Practice Address - Phone:817-461-0999
Practice Address - Fax:817-801-3121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16072122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty