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General NPI Number Information
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NPI Number | 1417002106
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Entity Type | Individual
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Provider Name | ROBERT LESTER BARRETT DDS
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 2802 HIGHWAY 367 N
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City | BALD KNOB
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State | AR
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Zip | 72010-3165
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Country | US
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Telephone | 870-724-6207
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Fax | 870-347-3492
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-2534
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Fax | 870-347-3492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2146 (17)
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2146
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License Number State | AR
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