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General NPI Number Information
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NPI Number | 1083336457
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Entity Type | Organization
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Legal Business Name | CARTER BECKHAM DMD PLLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 208 MAIN AVE S
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City | NORTH BEND
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State | WA
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Zip | 98045-8258
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Country | US
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Telephone | 425-888-6522
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Fax |
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Provider Business Mailing Address
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Address Line | 44114 SE 149TH PL
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City | NORTH BEND
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State | WA
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Zip | 98045-8847
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Country | US
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Telephone | 765-413-1076
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. CARTER BECKHAM
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Credential | DMD
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Telephone | 765-413-1076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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