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General NPI Number Information
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NPI Number | 1578846218
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Entity Type | Organization
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Legal Business Name | MANSFIELD SMILES AND ORTHODONTICS, PC
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Dates
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Enumeration Date | 09/20/2011
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 3300 E BROAD ST STE 120
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City | MANSFIELD
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State | TX
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Zip | 76063-5626
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Country | US
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Telephone | 682-518-5856
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Fax | 682-518-1532
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Provider Business Mailing Address
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Address Line | PO BOX 920050
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City | DALLAS
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State | TX
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Zip | 75392-0050
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Country | US
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Telephone | 714-368-2077
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Fax | 714-368-2092
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. JOHN S BARNES
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Credential | DDS
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Telephone | 682-518-5856
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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 |
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License Number State |
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