Provider Demographics
NPI:1225739295
Name:SWEET TOOTH BARRY ORTHODONTICS LLC
Entity Type:Organization
Organization Name:SWEET TOOTH BARRY ORTHODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:913-276-3809
Mailing Address - Street 1:15933 W 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66217-9342
Mailing Address - Country:US
Mailing Address - Phone:913-276-3809
Mailing Address - Fax:
Practice Address - Street 1:5 NW BARRY RD STE A
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64155-2728
Practice Address - Country:US
Practice Address - Phone:816-436-5949
Practice Address - Fax:816-436-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental