Provider Demographics
NPI:1174642284
Name:BEAM, ROY M (DDS)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:M
Last Name:BEAM
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 1:7001 INDIANA AVE
Mailing Address - Street 2:SUITE # 9
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-4100
Mailing Address - Country:US
Mailing Address - Phone:951-782-0093
Mailing Address - Fax:951-782-0096
Practice Address - Street 1:7001 INDIANA AVE
Practice Address - Street 2:SUITE # 9
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-4100
Practice Address - Country:US
Practice Address - Phone:951-782-0093
Practice Address - Fax:951-782-0096
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA427211223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry