MEDICARE: BEEMER DENTISTRY, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	03245	SC

General Provider Information

NPI Number	:	1134472699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEEMER DENTISTRY, PA

Provider Business Mailing Address
First Line	:	1512 N FANT ST
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-4708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 N FANT ST
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-4708
Country	:	US
Telephone Number	:	864-622-1313
Fax Number	:

Authorized Official
Title or Position	:	OFFICE STAFF
Name	:	JESSICA HOLLAND
Credential	:
Telephone Number	:	864-622-1313

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	10/22/2012

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Directions to “BEEMER DENTISTRY, PA ” Practice Location

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