Basic Information
| Provider Information | |||||||||
| NPI: | 1700144425 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BREWSTER | ||||||||
| FirstName: | JASPER | ||||||||
| MiddleName: | BERNARD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4312 GOLDEN HILLS DR | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372181404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6154142584 | ||||||||
| FaxNumber: | 6158760506 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 HART LN | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372431405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6156507060 | ||||||||
| FaxNumber: | 6152626139 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2012 | ||||||||
| LastUpdateDate: | 05/01/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223D0001X | DS0000006943 | TN | Y | Dental Providers | Dentist | Dental Public Health |
No ID Information.