Basic Information
| Provider Information | |||||||||
| NPI: | 1235446642 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNETT | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1122 SADDLE LN | ||||||||
| Address2: | |||||||||
| City: | SKIATOOK | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740703629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9188129388 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 360 PEAK ONE DR. | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | FRISCO | ||||||||
| State: | CO | ||||||||
| PostalCode: | 80443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706684040 | ||||||||
| FaxNumber: | 9706686699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2010 | ||||||||
| LastUpdateDate: | 12/30/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 00202111 | CO | Y | Dental Providers | Dentist | 1223G0001X | 6234 | OK | N | Dental Providers | Dentist | General Practice | 1223G0001X | 59639 | CA | N | Dental Providers | Dentist | General Practice |
No ID Information.