Provider Demographics
NPI:1922002948
Name:BARNETT FAMILY DENTAL DDD, PC
Entity Type:Organization
Organization Name:BARNETT FAMILY DENTAL DDD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:CARNEY
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:417-581-3600
Mailing Address - Street 1:1427 W STATE HIGHWAY J
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-7473
Mailing Address - Country:US
Mailing Address - Phone:417-581-3600
Mailing Address - Fax:471-581-8899
Practice Address - Street 1:1427 W STATE HIGHWAY J
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-7473
Practice Address - Country:US
Practice Address - Phone:417-581-3600
Practice Address - Fax:471-581-8899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO141281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty