MEDICARE: DR. GRANT BEYER D.M.D.

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	D11151	OR

General Provider Information

NPI Number	:	1598148512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRANT BEYER D.M.D.

Provider Business Mailing Address
First Line	:	333 WARNER MILNE RD STE A
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-4088
Country	:	US
Telephone Number	:	503-655-0613
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 WARNER MILNE RD STE A
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-4088
Country	:	US
Telephone Number	:	503-655-0613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2015
Last Update Date	:	09/21/2021

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