Provider Demographics
NPI:1295814523
Name:BARGE, LAURI BOYET (DDS)
Entity Type:Individual
Prefix:
First Name:LAURI
Middle Name:BOYET
Last Name:BARGE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3380 LONG PRAIRIE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-2715
Mailing Address - Country:US
Mailing Address - Phone:972-539-3800
Mailing Address - Fax:
Practice Address - Street 1:3380 LONG PRAIRIE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-2715
Practice Address - Country:US
Practice Address - Phone:972-539-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17877122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist