Provider Demographics
NPI:1861933392
Name:BARRETT IMPLANT & 3D FAMILY DENTISTRY
Entity type:Organization
Organization Name:BARRETT IMPLANT & 3D FAMILY DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:II
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-430-5045
Mailing Address - Street 1:2851 PLANO PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-6630
Mailing Address - Country:US
Mailing Address - Phone:214-430-5045
Mailing Address - Fax:
Practice Address - Street 1:2851 PLANO PKWY STE 220
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-6630
Practice Address - Country:US
Practice Address - Phone:214-430-5045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25352261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental