Provider Demographics
NPI:1174742910
Name:BARNES, JEFFREY A (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:BARNES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 MONTCLAIR RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-2427
Mailing Address - Country:US
Mailing Address - Phone:205-870-9971
Mailing Address - Fax:205-870-9560
Practice Address - Street 1:3940 MONTCLAIR RD
Practice Address - Street 2:SUITE 206
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-2427
Practice Address - Country:US
Practice Address - Phone:205-870-9971
Practice Address - Fax:205-870-9560
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist