Healthcare Provider Details

I. General information

NPI: 1679746762
Provider Name (Legal Business Name): KATE G BARNETTE D.M.D., M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2008
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10649 HIGHWAY 21
HILLSBORO MO
63050-5094
US

IV. Provider business mailing address

10649 HIGHWAY 21
HILLSBORO MO
63050-5094
US

V. Phone/Fax

Practice location:
  • Phone: 636-797-3400
  • Fax:
Mailing address:
  • Phone: 636-797-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2005018033
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: