| Beulah Dental Pc | |
|
200 W Main St Beulah ND 58523-6970 | |
| (701) 873-2259 | |
| Not Available |
| Full Name | Beulah Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 200 W Main St, Beulah, North Dakota |
| Authorized Official Name and Position | Kevin B Lee (PRESIDENT) |
| Authorized Official Contact | 7018732259 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beulah Dental Pc Po Box 118 Beulah ND 58523-0118 Ph: (701) 873-2259 | Beulah Dental Pc 200 W Main St Beulah ND 58523-6970 Ph: (701) 873-2259 |
| NPI Number | 1023483914 |
|---|---|
| Provider Enumeration Date | 12/03/2015 |
| Last Update Date | 12/03/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023483914 | NPI | - | NPPES |
| 1457382 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (North Dakota) | Primary |
Beulah Dental Weiss Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 W Main St, Beulah, ND 58523 Phone: 701-873-2259 |