Provider Demographics
NPI:1528345121
Name:PHILLIP C. BARNER, DDS
Entity type:Organization
Organization Name:PHILLIP C. BARNER, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:BARNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:401-233-3350
Mailing Address - Street 1:550 DOUGLAS PIKE
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-2347
Mailing Address - Country:US
Mailing Address - Phone:401-233-3350
Mailing Address - Fax:401-233-2251
Practice Address - Street 1:550 DOUGLAS PIKE
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2347
Practice Address - Country:US
Practice Address - Phone:401-233-3350
Practice Address - Fax:401-233-2251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN1777261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental