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General NPI Number Information
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NPI Number | 1245686252
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Entity Type | Organization
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Legal Business Name | EVAN A. BE, D.D.S., P.L.C.
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 1630 LINCOLN RD
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City | ALLEGAN
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State | MI
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Zip | 49010-9410
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Country | US
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Telephone | 734-377-7339
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Fax |
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Provider Business Mailing Address
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Address Line | 1630 LINCOLN RD
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City | ALLEGAN
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State | MI
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Zip | 49010-9410
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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 | DENTIST
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Name | EVAN BE
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Credential | D.D.S.
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Telephone | 734-377-7339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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