Provider Demographics
NPI:1710154273
Name:BARNES & LOUSCHER, D.D.S., LLC
Entity Type:Organization
Organization Name:BARNES & LOUSCHER, D.D.S., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-424-8062
Mailing Address - Street 1:2800 4TH ST SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-1596
Mailing Address - Country:US
Mailing Address - Phone:641-424-8062
Mailing Address - Fax:
Practice Address - Street 1:2800 4TH ST SW
Practice Address - Street 2:SUITE 1
Practice Address - City:MASON CITY
Practice Address - State:IA
Practice Address - Zip Code:50401-1596
Practice Address - Country:US
Practice Address - Phone:641-424-8062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6552122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty