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General NPI Number Information
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NPI Number | 1356164891
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Entity Type | Organization
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Legal Business Name | RYAN J BEYEA DDS PLLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 4780 OKEMOS RD STE 1
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City | OKEMOS
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State | MI
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Zip | 48864-1669
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Country | US
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Telephone | 517-281-8402
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Fax |
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Provider Business Mailing Address
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Address Line | 1615 CORKWOOD TRL
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City | WILLIAMSTON
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State | MI
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Zip | 48895-9122
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Country | US
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Telephone | 517-281-8402
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. RYAN J BEYEA
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Credential |
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Telephone | 517-281-8402
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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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