Provider Demographics
NPI:1881605608
Name:BARNETT & SHOFLICK, P.C.
Entity type:Organization
Organization Name:BARNETT & SHOFLICK, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STUART
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHOFLICK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-529-0624
Mailing Address - Street 1:22 BUCKINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2757
Mailing Address - Country:US
Mailing Address - Phone:860-231-8144
Mailing Address - Fax:
Practice Address - Street 1:2139 SILAS DEANE HWY
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2336
Practice Address - Country:US
Practice Address - Phone:860-529-0624
Practice Address - Fax:860-721-0407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT76501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty