Mary K. Booth, DDS

Dentist · Decatur, IL

Individual Active NPI

NPI number 1629205554

Practice location

3250 N Woodford St
Decatur, IL 62526-2836
Phone
(217) 877-1742

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NPI record

NPI
1629205554
Entity type
Individual (Type 1)
Enumeration date
June 18, 2009
Last updated
August 9, 2023
Certified
August 9, 2023
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019027977 IL

About Dr. Booth

Mary K. Booth, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 3250 N Woodford St, Decatur, IL 62526-2836. The NPI number 1629205554 was assigned on June 18, 2009 and the record was last updated on August 9, 2023.

Dr. Booth lists a license in the registry: #019027977 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Mary K. Booth, DDS?

The NPI number is 1629205554.

What is the phone number of Dr. Booth?

The phone number listed for the practice location is (217) 877-1742.

Where is Dr. Booth located?

3250 N Woodford St, Decatur, IL 62526-2836.

What is the taxonomy code for Dr. Booth?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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