Healthcare Provider Details
I. General information
NPI: 1437639291
Provider Name (Legal Business Name): BEECH & REID DENTAL PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/20/2018
Last Update Date: 08/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1565 HOLLENBECK AVE STE 104
SUNNYVALE CA
94087-4300
US
IV. Provider business mailing address
1565 HOLLENBECK AVE STE 104
SUNNYVALE CA
94087-4300
US
V. Phone/Fax
- Phone: 408-245-6010
- Fax: 408-245-6018
- Phone: 408-245-6010
- Fax: 408-245-6018
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | 61340 |
| License Number State | CA |
VIII. Authorized Official
Name:
ROBERT
ANTHONY
BEECH
Title or Position: OWNER/ ORAL SURGEON
Credential: DDS
Phone: 408-245-6010