Ronald Phillip Beasley Jr., DMD

Individual provider Active NPI General Practice Dentistry · Birmingham, AL

NPI 1275740714 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1275740714
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4998 (AL)
Practice address
1841 Montclaire LN
Suite 101
Birmingham, AL 35216-1864
Phone
(205) 823-1473
Fax
(205) 823-1473
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4998ALMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4998 AL Yes

Addresses

Primary practice location

1841 Montclaire LN
Suite 101
Birmingham, AL 35216-1864

Mailing address

1841 Montclaire LN
Suite 101
Birmingham, AL 35216-1864
Phone (205) 936-2595

Other providers in Birmingham, AL

All providers in Birmingham, AL · General Practice Dentistry in Alabama

Sources for this page

Verify at the official NPI Registry.