Organization Name: | KENNETH E. BEARD, DDS,PC |
NPI Number: | 1003160599 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH E BEARD (PRESIDENT) |
Mailing Address: | 415 25th St Nw Cleveland |
State: | TN US |
Postal Code: | 373113892 |
Phone Number: | 4234766541 |
Fax Number: | 4234727719 |
NPI Enumeration Date: | 11/05/2012 |
NPI Last Update Date: | 11/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |