Provider Demographics
NPI:1275638462
Name:BARRETT, CHARLES HALSEY (DDS)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:HALSEY
Last Name:BARRETT
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 1:1230 ALVERSER DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2653
Mailing Address - Country:US
Mailing Address - Phone:804-794-2144
Mailing Address - Fax:804-378-3587
Practice Address - Street 1:1230 ALVERSER DR
Practice Address - Street 2:SUITE 104
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2653
Practice Address - Country:US
Practice Address - Phone:804-794-2144
Practice Address - Fax:804-378-3587
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010054721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice