Healthcare Provider Details

I. General information

NPI: 1306254396
Provider Name (Legal Business Name): BRETT BARNETTE DDS, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 48TH AVE N UNIT 101
MYRTLE BEACH SC
29577-5446
US

IV. Provider business mailing address

1200 48TH AVE N UNIT 101
MYRTLE BEACH SC
29577-5446
US

V. Phone/Fax

Practice location:
  • Phone: 843-449-4993
  • Fax:
Mailing address:
  • Phone: 843-449-4993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0008665
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number4524
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number11351
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: