Provider Demographics
NPI:1730721911
Name:J T BRINKLEY & ASSOCIATES, PC
Entity type:Organization
Organization Name:J T BRINKLEY & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-640-0457
Mailing Address - Street 1:6842 MORRISON BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-3500
Mailing Address - Country:US
Mailing Address - Phone:704-417-5888
Mailing Address - Fax:
Practice Address - Street 1:6842 MORRISON BLVD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-3500
Practice Address - Country:US
Practice Address - Phone:704-417-5888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental