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Provider Information for 1700939196



DR. BARTEL VANOOSTENDORP V D.D.S.

Gender: MALE

Individual NPI: 1700939196

Calendar Last Updated: 2014-01-14

Details

Name Value
NPI 1700939196
Enumeration Date 2007-01-19
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 4 MARKET ST STE 4202
BREVARD, NC 28712-5637
United States

Phone: 828-884-3702 | Fax: 828-877-4065
View Map External Link
Primary Practice Address 4 MARKET ST STE 4202
BREVARD, NC 28712-5637
United States

Phone: 828-884-3702 | Fax: 828-877-4065
View Map External Link
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NC NC8913
No 1223G0001X - Dentist General Practice AZ 5677
Other Identifiers
Issuer State Number
Endpoint Information
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location