Provider Demographics
NPI:1215192869
Name:ROCHEFORT, BARRETT MAX (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:MAX
Last Name:ROCHEFORT
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 1:2046 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2700
Mailing Address - Country:US
Mailing Address - Phone:206-284-4505
Mailing Address - Fax:206-284-4757
Practice Address - Street 1:2046 WESTLAKE AVE N
Practice Address - Street 2:SUITE 204
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2700
Practice Address - Country:US
Practice Address - Phone:206-284-4505
Practice Address - Fax:206-284-4757
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE400004151122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist