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General NPI Number Information
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NPI Number | 1831592039
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Entity Type | Organization
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Legal Business Name | BEARLEY DENTAL PC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 901 PRESTON AVE, SUITE 200
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903
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Country | US
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Telephone | 434-296-8034
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Fax | 434-296-8424
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Provider Business Mailing Address
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Address Line | 901 PRESTON AVE, SUITE 200
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903
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Country | US
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Telephone | 434-296-8034
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Fax | 434-296-8424
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL LEE BEARLEY
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Credential | DDS
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Telephone | 434-296-8034
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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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