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General NPI Number Information
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NPI Number | 1356860324
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Entity Type | Organization
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Legal Business Name | BRETT R. HENSON, DDS, PA
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Dates
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Enumeration Date | 09/11/2017
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Last Update Date | 07/04/2019
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Provider Practice Location Address
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Address Line | 640 STATESVILLE BLVD STE 3
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City | SALISBURY
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State | NC
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Zip | 28144-2215
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Country | US
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Telephone | 704-637-3636
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Fax | 704-637-3184
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Provider Business Mailing Address
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Address Line | 640 STATESVILLE BLVD STE 3
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City | SALISBURY
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State | NC
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Zip | 28144-2215
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Country | US
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Telephone | 704-637-3636
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Fax | 704-637-3184
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. BRETT R. HENSON
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Credential | DDS
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Telephone | 704-637-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 10610
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License Number State | NC
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