Provider Demographics
NPI:1720147382
Name:BRENT J. JARRETT, DDS
Entity type:Organization
Organization Name:BRENT J. JARRETT, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:JUSTIN
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-979-2323
Mailing Address - Street 1:7312 W ATLANTIC BLVD
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-4217
Mailing Address - Country:US
Mailing Address - Phone:954-979-2323
Mailing Address - Fax:954-979-0012
Practice Address - Street 1:7312 W ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-4217
Practice Address - Country:US
Practice Address - Phone:954-979-2323
Practice Address - Fax:954-979-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL152971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty