Provider Demographics
NPI:1003014184
Name:BEERS, ADAM RUSSELL (DDS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:RUSSELL
Last Name:BEERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:56087-0009
Mailing Address - Country:US
Mailing Address - Phone:507-723-4375
Mailing Address - Fax:507-723-4378
Practice Address - Street 1:602 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MN
Practice Address - Zip Code:56087-4502
Practice Address - Country:US
Practice Address - Phone:507-723-4375
Practice Address - Fax:507-723-4378
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND122691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice