Provider Demographics
NPI:1073615464
Name:BEELER CONNER, KRISTEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:
Last Name:BEELER CONNER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KRISTEN
Other - Middle Name:DUNCAN
Other - Last Name:BEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:4972 HIGHWAY 58 STE 114
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-1868
Mailing Address - Country:US
Mailing Address - Phone:423-894-5223
Mailing Address - Fax:423-894-5224
Practice Address - Street 1:4972 HIGHWAY 58 STE 114
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37416
Practice Address - Country:US
Practice Address - Phone:423-894-5223
Practice Address - Fax:423-894-5224
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN83791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice