Provider Demographics
NPI:1346403367
Name:IBARRA, BRET A (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:BRET
Middle Name:A
Last Name:IBARRA
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Gender:M
Credentials:DDS, MSD
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Mailing Address - Street 1:12700 N FEATHERWOOD DR
Mailing Address - Street 2:STE 290
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-4439
Mailing Address - Country:US
Mailing Address - Phone:281-484-7732
Mailing Address - Fax:281-484-8751
Practice Address - Street 1:12700 N FEATHERWOOD DR
Practice Address - Street 2:STE 290
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4439
Practice Address - Country:US
Practice Address - Phone:281-484-7732
Practice Address - Fax:281-484-8751
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2011-01-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX234801223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry