Provider Demographics
NPI:1518097492
Name:BARNETT, SCOTT R (DMD,FAGD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:BARNETT
Suffix:
Gender:M
Credentials:DMD,FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 COGSWELL AVE
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-1644
Mailing Address - Country:US
Mailing Address - Phone:205-884-2370
Mailing Address - Fax:205-338-0971
Practice Address - Street 1:1605 COGSWELL AVE
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-1644
Practice Address - Country:US
Practice Address - Phone:205-884-2370
Practice Address - Fax:205-338-0971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL40691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice