Provider Demographics
NPI:1780718494
Name:BARWISE, BRITT V (DDS)
Entity type:Individual
Prefix:DR
First Name:BRITT
Middle Name:V
Last Name:BARWISE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1220 AIRLINE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-3473
Mailing Address - Country:US
Mailing Address - Phone:361-993-9551
Mailing Address - Fax:361-991-7887
Practice Address - Street 1:1220 AIRLINE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-3473
Practice Address - Country:US
Practice Address - Phone:361-993-9551
Practice Address - Fax:361-991-7887
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX152851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice