Healthcare Provider Details

I. General information

NPI: 1700103447
Provider Name (Legal Business Name): PAUL MICHAEL BEYT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2010
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N MAIN ST
SAINT MARTINVILLE LA
70582-4120
US

IV. Provider business mailing address

509 N MAIN ST
SAINT MARTINVILLE LA
70582-4120
US

V. Phone/Fax

Practice location:
  • Phone: 337-394-3768
  • Fax: 337-394-7131
Mailing address:
  • Phone: 337-394-3768
  • Fax: 337-394-7131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6250
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: