Provider Demographics
NPI:1114243300
Name:BAREFOOT, BROOKS
Entity Type:Individual
Prefix:MR
First Name:BROOKS
Middle Name:
Last Name:BAREFOOT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10450 PARK MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-5529
Mailing Address - Country:US
Mailing Address - Phone:303-779-0565
Mailing Address - Fax:
Practice Address - Street 1:10450 PARK MEADOWS DR STE 300
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5530
Practice Address - Country:US
Practice Address - Phone:303-779-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN-104171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics