Provider Demographics
NPI:1851062541
Name:BRENT HAYWARD BARROSO-BERNIER DDS PLLC
Entity Type:Organization
Organization Name:BRENT HAYWARD BARROSO-BERNIER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:DOTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-450-1286
Mailing Address - Street 1:2159 HENDERSONVILLE RD STE 10
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-9721
Mailing Address - Country:US
Mailing Address - Phone:828-676-0065
Mailing Address - Fax:828-676-1070
Practice Address - Street 1:2159 HENDERSONVILLE RD STE 10
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-9721
Practice Address - Country:US
Practice Address - Phone:828-676-0065
Practice Address - Fax:828-676-1070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty