Provider Demographics
NPI:1124208137
Name:LYNNE E BARBOUR DDS PC
Entity Type:Organization
Organization Name:LYNNE E BARBOUR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:660-727-4746
Mailing Address - Street 1:203 E COMMERCIAL
Mailing Address - Street 2:
Mailing Address - City:KAHOKA
Mailing Address - State:MO
Mailing Address - Zip Code:63445
Mailing Address - Country:US
Mailing Address - Phone:660-727-4746
Mailing Address - Fax:660-727-4747
Practice Address - Street 1:203 E COMMERCIAL
Practice Address - Street 2:
Practice Address - City:KAHOKA
Practice Address - State:MO
Practice Address - Zip Code:63445
Practice Address - Country:US
Practice Address - Phone:660-727-4746
Practice Address - Fax:660-727-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty