| Barry E. Booth, D.D.S., M.S. | |
|
12635 W 143rd St Homer Glen IL 60491-8381 | |
| (708) 301-0005 | |
| (708) 301-0063 |
| Full Name | Barry E. Booth, D.D.S., M.S. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 12635 W 143rd St, Homer Glen, Illinois |
| Authorized Official Name and Position | Barry E. Booth (PRESIDENT) |
| Authorized Official Contact | 7083010005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Barry E. Booth, D.D.S., M.S. 12635 W 143rd St Homer Glen IL 60491-8381 Ph: (708) 301-0005 | Barry E. Booth, D.D.S., M.S. 12635 W 143rd St Homer Glen IL 60491-8381 Ph: (708) 301-0005 |
| NPI Number | 1740329093 |
|---|---|
| Provider Enumeration Date | 02/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740329093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (Illinois) | Primary |
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