Provider Demographics
NPI:1093021362
Name:BARNTS, KELCIE LOUISE (DDS)
Entity type:Individual
Prefix:DR
First Name:KELCIE
Middle Name:LOUISE
Last Name:BARNTS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 COLE AVE STE 930
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4183
Mailing Address - Country:US
Mailing Address - Phone:855-672-5728
Mailing Address - Fax:214-666-5314
Practice Address - Street 1:4514 COLE AVE STE 930
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-4183
Practice Address - Country:US
Practice Address - Phone:556-725-7288
Practice Address - Fax:214-666-5314
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59612122300000X
PADS0433461223P0106X
TX398801223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
No122300000XDental ProvidersDentist