Robert Beadle, DS
Individual provider Active NPI General Practice Dentistry · Phila, PA
NPI 1154475853 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154475853
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS025989L (PA)
- Practice address
- 626 Snyder Ave
Phila, PA 19148-2419 - Phone
- (215) 334-4900
- Fax
- (215) 334-9721
- NPI assigned
- Jan 22, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS025989L | PA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS025989L | PA | Yes |
Addresses
Primary practice location
626 Snyder Ave
Phila, PA 19148-2419
Mailing address
432 N 6TH St
Phila, PA 19123-4004
Phone (215) 925-2400
Other providers in Phila, PA
- Gregory Micheal Bartle
- Faye Barychewsky
- Brigid B Bautista
- Catalina Bautista
- Eileen Amy Bazelon
- Markeeta Y Beckham
- William Beckwith
- Carrie-Ann Begnaud
- Bell-Edge Drugs Inc
- Philip J. Bell
All providers in Phila, PA · General Practice Dentistry in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.