Provider Demographics
NPI:1982996864
Name:ROBERT J BARNETT DDS PA
Entity Type:Organization
Organization Name:ROBERT J BARNETT DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID / FRONT ONFFICE
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-624-7129
Mailing Address - Street 1:102 RIDGEWAY ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7100
Mailing Address - Country:US
Mailing Address - Phone:501-624-7129
Mailing Address - Fax:501-624-2471
Practice Address - Street 1:102 RIDGEWAY ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7100
Practice Address - Country:US
Practice Address - Phone:501-624-7129
Practice Address - Fax:501-624-2471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR24811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR168852631Medicaid