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General NPI Number Information
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NPI Number | 1003032988
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Entity Type | Organization
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Legal Business Name | JOHN R BEATTIE, DDS, PA
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 07/30/2008
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Provider Practice Location Address
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Address Line | 960 LAKE BALDWIN LN
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City | ORLANDO
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State | FL
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Zip | 32814-6651
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Country | US
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Telephone | 407-898-2901
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Fax |
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Provider Business Mailing Address
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Address Line | 960 LAKE BALDWIN LN
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City | ORLANDO
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State | FL
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Zip | 32814-6651
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ROBERT BEATTIE
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Credential | D.D.S, M.S.D
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Telephone | 407-898-2901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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