Nathan K. Beavers Dmd Pllc

NPI 1003138967 - Dentist - 1223P0221X

NPI Details
NPI 1003138967
Enumeration Date 02/19/2010
Last Updated 02/19/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name NATHAN NATHAN
Position MANAGING PARTNER
Phone (601) 856-5313
Fax
Practice Location
119 COLONY CROSSING WAY
SUITE 740
MADISON MS, 39110-6322, US
Phone (601) 856-5313
Fax
Business Location
119 COLONY CROSSING WAY
SUITE 740
MADISON MS, 39110-6322, US
Phone (601) 856-5313
Fax
Toxanomy
Taxonomy Code 1223P0221X
License State Mississippi
License Number PEDO 377-04
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According to our database, Nathan K. Beavers Dmd Pllc NPI is 1003138967, taxonomy code is 1223P0221X and license number is PEDO 377-04, license state is located at Mississippi. Nathan K. Beavers Dmd Pllc physically located at 119 Colony Crossing Way, Madison MS, 39110-6322. NPI Number 1033115704 has the healthcare provider type.

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1003138967 NPI number is provided on an as is basis without warranty of any kind. 1003138967 is maintained by the National Plan & Provider Enumeration System. The contents of Nathan K. Beavers Dmd Pllc are for informational purposes only.