Provider Demographics
NPI:1255789038
Name:BARTS-NUNEZ, CAITLIN (DDS)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:BARTS-NUNEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 E. 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IN
Mailing Address - Zip Code:46975
Mailing Address - Country:US
Mailing Address - Phone:574-223-7792
Mailing Address - Fax:574-224-7792
Practice Address - Street 1:1360 E. 4TH STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:IN
Practice Address - Zip Code:46975
Practice Address - Country:US
Practice Address - Phone:574-223-7792
Practice Address - Fax:574-224-7792
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012472A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist