Barry E. Booth, D.D.S., M.S.

Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Homer Glen, IL

NPI 1740329093 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1740329093
Entity type
Organization (NPI type 2)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
Legal business name
BARRY E. BOOTH, D.D.S., M.S.
Practice address
12635 W 143Rd St
Homer Glen, IL 60491-8381
Phone
(708) 301-0005
Fax
(708) 301-0063
NPI assigned
Feb 5, 2007
Organization subpart
No

Authorized official

Name
Dr. Barry E. Booth, D.D.S., M.S.
Title
President
Phone
(708) 301-0005

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223X0400X IL Yes

Addresses

Primary practice location

12635 W 143Rd St
Homer Glen, IL 60491-8381

Mailing address

12635 W 143Rd St
Homer Glen, IL 60491-8381
Phone (708) 301-0005

Other providers in Homer Glen, IL

All providers in Homer Glen, IL · Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.