Provider Demographics
NPI:1750677431
Name:HESTER, BRETT JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRETT
Middle Name:JAMES
Last Name:HESTER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W MOORE ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2917
Mailing Address - Country:US
Mailing Address - Phone:229-247-3400
Mailing Address - Fax:229-242-1808
Practice Address - Street 1:114 W MOORE ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2917
Practice Address - Country:US
Practice Address - Phone:229-247-3400
Practice Address - Fax:229-242-1808
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0143051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice