Provider Demographics
NPI:1588293534
Name:BRETT C DENHART DMD MD PC
Entity type:Organization
Organization Name:BRETT C DENHART DMD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:DENHART
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DMD
Authorized Official - Phone:413-320-9057
Mailing Address - Street 1:1066 GRANBY RD
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1539
Mailing Address - Country:US
Mailing Address - Phone:413-320-9057
Mailing Address - Fax:
Practice Address - Street 1:1066 GRANBY RD
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1539
Practice Address - Country:US
Practice Address - Phone:413-320-9057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty