Organization
BARRY E. BOOTH, D.D.S., M.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY E. BOOTH D.D.S., M.S. (PRESIDENT)
(708) 301-0005
Entity
Organization
Contact information
Practice address
12635 W 143RD ST, HOMER GLEN, IL 60491-8381
(708) 301-0005
(708) 301-0063
Mailing address
12635 W 143RD ST, HOMER GLEN, IL 60491-8381
(708) 301-0005
(708) 301-0063
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
02/05/2007
Last updated
08/22/2020
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