Provider Demographics
NPI:1417032111
Name:BARRETT, EDWARD J (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:BARRETT
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3100
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80161-3100
Mailing Address - Country:US
Mailing Address - Phone:720-529-5777
Mailing Address - Fax:303-792-0347
Practice Address - Street 1:6650 S. VINE ST
Practice Address - Street 2:L-80
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121
Practice Address - Country:US
Practice Address - Phone:720-529-5777
Practice Address - Fax:303-792-0347
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1052751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics