Healthcare Provider Details

I. General information

NPI: 1821186966
Provider Name (Legal Business Name): GERARD MICHAEL BEYT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 S MAIN ST
SAINT MARTINVILLE LA
70582-4510
US

IV. Provider business mailing address

306 S MAIN ST
SAINT MARTINVILLE LA
70582-4510
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3251
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: