Individual
SUZANNE BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
501 S PRESTON ST, LOUISVILLE, KY 40202-1701
(502) 852-5401
Mailing address
218 BLISS AVE, LOUISVILLE, KY 40243-1065
(863) 529-6060
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10571
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
10571
KY
Other
Enumeration date
05/03/2016
Last updated
09/06/2021
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