Individual
MICAH DANIELLE BARTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
804 N HIGHWAY 5, MANSFIELD, MO 65704-7301
(417) 924-8809
Mailing address
2431 S FREMONT AVE, SPRINGFIELD, MO 65804-3105
(417) 293-7307
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2019018801
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2019018801
MISSOURI PROFESSIONAL LICENSE
MO
Enumeration date
06/13/2019
Last updated
04/04/2024
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