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NPI 1487531497

NPI 1487531497 : RILEY BARNETT DMD : FORT POLK, LA

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General NPI Number Information
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    NPI Number           |    1487531497
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    Entity Type          |    Individual 
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    Provider Name        |    RILEY BARNETT DMD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/20/2025
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    Last Update Date     |    08/20/2025
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Provider Practice Location Address
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    Address Line         |    7223 MISSISSIPPI AVE 
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    City                 |    FORT POLK
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    State                |    LA
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    Zip                  |    71459
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    Country              |    US
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    Telephone            |    726-780-1290
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7223 MISSISSIPPI AVE BLDG 1561
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    City                 |    FORT POL
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    State                |    LA
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    Zip                  |    71459
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    Country              |    US
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    Telephone            |    726-780-1290
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    Fax                  |    
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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        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    11230
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    License Number State |    SC
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