Provider Demographics
NPI:1346229143
Name:BARKLEY, MARY KATHERINE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:KATHERINE
Last Name:BARKLEY
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:1305 SOUTH MAIN STREET
Mailing Address - Street 2:PIERCE LAKE PROFESSIONAL CENTER
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1515
Mailing Address - Country:US
Mailing Address - Phone:734-475-9143
Mailing Address - Fax:734-475-5946
Practice Address - Street 1:1305 SOUTH MAIN STREET
Practice Address - Street 2:PIERCE LAKE PROFESSIONAL CENTER
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1515
Practice Address - Country:US
Practice Address - Phone:734-475-9143
Practice Address - Fax:734-475-5946
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI29010140481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics