Provider Demographics
NPI:1447445994
Name:CLINT BARRETT, D.D.S., INC.
Entity type:Organization
Organization Name:CLINT BARRETT, D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-792-6291
Mailing Address - Street 1:7515 QUAKER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-5308
Mailing Address - Country:US
Mailing Address - Phone:806-792-6291
Mailing Address - Fax:806-792-6329
Practice Address - Street 1:7515 QUAKER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-5308
Practice Address - Country:US
Practice Address - Phone:806-792-6291
Practice Address - Fax:806-792-6329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty