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General NPI Number Information
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NPI Number | 1891876595
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Entity Type | Organization
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Legal Business Name | BAYLON BEINLICH DDS LLC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9950 VALLEY CREEK RD SUITE 150
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City | WOODBURY
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State | MN
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Zip | 55125-4883
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Country | US
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Telephone | 651-702-1462
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Fax | 651-702-3828
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Provider Business Mailing Address
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Address Line | 5972 CAHILL AVE SUITE 112
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-5500
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Country | US
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Telephone | 651-450-0487
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Fax | 651-450-1290
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Authorized Official
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Title or Position | PARTNER
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Name | DR. GREG S BEINLICH
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Credential | D.D.S.,M.S.
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Telephone | 651-702-1462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2989128
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License Number State | MN
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