Provider Demographics
NPI:1497868046
Name:FLETCHER-BARNES, VICTORIA CHARVENE (DDS)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:CHARVENE
Last Name:FLETCHER-BARNES
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 1:1670 SPRINGDALE DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:803-432-3368
Practice Address - Street 1:1670 SPRINGDALE DR
Practice Address - Street 2:SUITE 7
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020
Practice Address - Country:US
Practice Address - Phone:803-432-3338
Practice Address - Fax:803-432-3368
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35941223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ35944Medicaid