Provider Demographics
NPI:1578864039
Name:BARNETT, MARLENE (RDH)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:
Last Name:BARNETT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SERVICE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3821
Mailing Address - Country:US
Mailing Address - Phone:413-586-3140
Mailing Address - Fax:413-784-1037
Practice Address - Street 1:23 SERVICE CENTER RD
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3821
Practice Address - Country:US
Practice Address - Phone:413-586-3140
Practice Address - Fax:413-784-1037
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH5630124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist