Provider Demographics
NPI:1457437303
Name:BARBARA L. BRESSERT, D.D.S., P.A.
Entity Type:Organization
Organization Name:BARBARA L. BRESSERT, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRESSERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:828-765-7383
Mailing Address - Street 1:54 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-8937
Mailing Address - Country:US
Mailing Address - Phone:828-765-7383
Mailing Address - Fax:828-765-5293
Practice Address - Street 1:54 BROAD ST
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-8937
Practice Address - Country:US
Practice Address - Phone:828-765-7383
Practice Address - Fax:828-765-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC58961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89-91072Medicaid
NC1992722334OtherINDIVIDUAL NPI NUMBER
NC89-91072Medicaid