Provider Demographics
NPI:1548306707
Name:TOOTHMAN, BARTH M (DDS)
Entity type:Individual
Prefix:
First Name:BARTH
Middle Name:M
Last Name:TOOTHMAN
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 1:1920 BETHEL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-1802
Mailing Address - Country:US
Mailing Address - Phone:614-457-4585
Mailing Address - Fax:614-457-6047
Practice Address - Street 1:1920 BETHEL RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-1802
Practice Address - Country:US
Practice Address - Phone:614-457-4585
Practice Address - Fax:614-457-6047
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-68661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice