Provider Demographics
NPI:1750722807
Name:BARQUET, CHARLES (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:BARQUET
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 S LAMAR ST APT 218
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-6814
Mailing Address - Country:US
Mailing Address - Phone:504-606-3049
Mailing Address - Fax:
Practice Address - Street 1:2604 OLD DENTON RD STE 112
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5137
Practice Address - Country:US
Practice Address - Phone:972-323-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX324011223G0001X
SCDGD.8261 GD1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice