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General NPI Number Information
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NPI Number | 1548397029
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Entity Type | Individual
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Provider Name | DANIEL TILMON BEENE DDS
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/10/2009
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Provider Practice Location Address
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Address Line | 615 N JACKSON ST
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City | MAGNOLIA
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State | AR
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Zip | 71753-2462
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Country | US
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Telephone | 870-234-1110
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Fax | 870-234-1112
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Provider Business Mailing Address
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Address Line | PO BOX 1133 615 N. JACKSON ST.
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City | MAGNOLIA
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State | AR
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Zip | 71754-1133
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Country | US
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Telephone | 870-234-1110
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Fax | 870-234-1112
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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 | 3485
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License Number State | AR
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