MEDICARE: MICHAEL DAVID BARRETT DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE60472861	WA

General Provider Information

NPI Number	:	1528472925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL DAVID BARRETT DMD

Provider Business Mailing Address
First Line	:	PO BOX 387
Second Line	:
City	:	EVERSON
State	:	WA
Zip	:	98247-0387
Country	:	US
Telephone Number	:	360-966-7777
Fax Number	:	360-966-4510

Provider Business Practice Location Address
First Line	:	201 E MAIN ST
Second Line	:
City	:	EVERSON
State	:	WA
Zip	:	98247-9126
Country	:	US
Telephone Number	:	360-966-7777
Fax Number	:	360-966-4510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2014
Last Update Date	:	06/13/2014

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Directions to “ MICHAEL DAVID BARRETT DMD” Practice Location

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