Provider Demographics
NPI:1740023886
Name:LABARCA, ANNEMARIE (DDS)
Entity type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:LABARCA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11901 CORRIDOR LN APT 204
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-7895
Mailing Address - Country:US
Mailing Address - Phone:816-560-4163
Mailing Address - Fax:
Practice Address - Street 1:2601 CLARKE AVE
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:23801
Practice Address - Country:US
Practice Address - Phone:804-734-9607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024021491122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist