| Dudley C. Beaty Iii, Dmd, Pc | |
| 225 Broad St Bennettsville SC 29512-4003 | |
| (843) 479-0305 | |
| Not Available | 
| Full Name | Dudley C. Beaty Iii, Dmd, Pc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 225 Broad St, Bennettsville, South Carolina | 
| Authorized Official Name and Position | Dudley C. Beaty (OWNER) | 
| Authorized Official Contact | 8434790305 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dudley C. Beaty Iii, Dmd, Pc 225 Broad St Bennettsville SC 29512-4003 Ph: (843) 479-0305 | Dudley C. Beaty Iii, Dmd, Pc 225 Broad St Bennettsville SC 29512-4003 Ph: (843) 479-0305 | 
| NPI Number | 1376693937 | 
|---|---|
| Provider Enumeration Date | 01/12/2007 | 
| Last Update Date | 08/22/2020 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1376693937 | NPI | - | NPPES | 
| 2906 | Other | SC | DELTA DENTAL PROVIDER # | 
| ZA9903 | Medicaid | SC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary | 
| Marlboro Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 307 E Main St, Bennettsville, SC 29512 Phone: 843-479-4781 Fax: 843-479-3117 | |
| Marlboro Family Dentistry Associates Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 E Main St, Bennettsville, SC 29512 Phone: 843-479-4781 Fax: 843-456-5089 |