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General NPI Number Information
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NPI Number | 1396419495
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Entity Type | Individual
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Provider Name | MATTHEW ORESTE BEAUCHEMIN DMD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2021
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 505 REALTY ST SW
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City | LENOIR
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State | NC
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Zip | 28645-5567
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Country | US
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Telephone | 287-542-6008
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Fax |
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Provider Business Mailing Address
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Address Line | 505 REALTY ST SW
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City | LENOIR
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State | NC
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Zip | 28645-5567
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Country | US
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Telephone | 954-394-5926
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 12426
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License Number State | NC
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