Healthcare Provider Details

I. General information

NPI: 1710293584
Provider Name (Legal Business Name): BRETT BARRY HULET DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2010
Last Update Date: 08/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SHEPPARD AFB 82D DS 149 HART ST. SUITE 4
APO AA
76311-3481
US

IV. Provider business mailing address

SHEPPARD AFB 82D DS 149 HART ST. SUITE 4
APO AA
76311-3481
US

V. Phone/Fax

Practice location:
  • Phone: 940-676-4474
  • Fax:
Mailing address:
  • Phone: 940-676-4474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD-4329
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: