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General NPI Number Information
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NPI Number | 1053494351
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Entity Type | Organization
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Legal Business Name | MICHAEL A. BEIM, D.D.S., P.A.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 345 WAYMONT CT
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City | LAKE MARY
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State | FL
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Zip | 32746-3575
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Country | US
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Telephone | 407-323-0600
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Fax | 407-330-0171
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Provider Business Mailing Address
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Address Line | 345 WAYMONT CT
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City | LAKE MARY
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State | FL
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Zip | 32746-3575
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Country | US
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Telephone | 407-323-0600
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Fax | 407-330-0171
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL ALLEN BEIM
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Credential | D.D.S.
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Telephone | 407-323-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN 11929
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License Number State | FL
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