Healthcare Provider Details

I. General information

NPI: 1235505751
Provider Name (Legal Business Name): RICHARD D BARNETT DMD PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2015
Last Update Date: 08/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 S 10TH ST
MIDDLESBORO KY
40965-1058
US

IV. Provider business mailing address

106 S 10TH ST
MIDDLESBORO KY
40965-1058
US

V. Phone/Fax

Practice location:
  • Phone: 606-248-7505
  • Fax:
Mailing address:
  • Phone: 606-248-7505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6553
License Number StateKY

VIII. Authorized Official

Name: DR. RICHARD D BARNETT
Title or Position: OWNER
Credential:
Phone: 606-248-7505