Provider Demographics
NPI:1083622062
Name:BARNETT, LARRY EDGAR (DDS)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:EDGAR
Last Name:BARNETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 SHENANGO VALLEY FRWY
Mailing Address - Street 2:SUITE 1S PINEWOOD PLACE
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148
Mailing Address - Country:US
Mailing Address - Phone:724-347-7988
Mailing Address - Fax:724-347-6103
Practice Address - Street 1:1951 SHENANGO VALLEY FRWY
Practice Address - Street 2:SUITE 1S PINEWOOD PLACE
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148
Practice Address - Country:US
Practice Address - Phone:724-347-7988
Practice Address - Fax:724-347-6103
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025411L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist