Provider Demographics
NPI:1700144425
Name:BREWSTER, JASPER BERNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASPER
Middle Name:BERNARD
Last Name:BREWSTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4312 GOLDEN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37218-1404
Mailing Address - Country:US
Mailing Address - Phone:615-414-2584
Mailing Address - Fax:615-876-0506
Practice Address - Street 1:710 HART LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37243-1405
Practice Address - Country:US
Practice Address - Phone:615-650-7060
Practice Address - Fax:615-262-6139
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000069431223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health