1164635710 NPI number — DR. BARRY F. MCARDLE GENERAL DENTIST, PA

Table of content: DR. CYNTHIA MAE OWEN MD (NPI 1013953405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164635710 NPI number — DR. BARRY F. MCARDLE GENERAL DENTIST, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. BARRY F. MCARDLE GENERAL DENTIST, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164635710
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
118 MAPLEWOOD AVE
Provider Second Line Business Mailing Address:
SUITE B-7
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03801-3787
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-430-1010
Provider Business Mailing Address Fax Number:
603-430-3050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
118 MAPLEWOOD AVE
Provider Second Line Business Practice Location Address:
SUITE B-7
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03801-3787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-430-1010
Provider Business Practice Location Address Fax Number:
603-430-3050
Provider Enumeration Date:
05/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCARDLE
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
F
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
603-430-1010

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2038 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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