Healthcare Provider Details

I. General information

NPI: 1962176651
Provider Name (Legal Business Name): ALEC JOSEPH BEEGHLY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2021
Last Update Date: 08/05/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1508 MAPLE GROVE CHURCH RD
DUNN NC
28334-7688
US

IV. Provider business mailing address

330 SUMMER RANCH DR.
FUQUAY-VARINA NC
27526
US

V. Phone/Fax

Practice location:
  • Phone: 877-935-5255
  • Fax:
Mailing address:
  • Phone: 859-486-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12317
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number12317
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: