Provider Demographics
NPI:1346349081
Name:KATHLEEN E. BARRETT, D.M.D.,P.C.
Entity Type:Organization
Organization Name:KATHLEEN E. BARRETT, D.M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-965-3830
Mailing Address - Street 1:345 BOYLSTON ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2863
Mailing Address - Country:US
Mailing Address - Phone:617-965-3830
Mailing Address - Fax:
Practice Address - Street 1:345 BOYLSTON ST
Practice Address - Street 2:SUITE 401
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-2863
Practice Address - Country:US
Practice Address - Phone:617-965-3830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA161151223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX05823BAOtherBLUE CROSS/BLUE SHIELD