Provider Demographics
NPI:1184200388
Name:BEEDY, BRIANA (RDH)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:BEEDY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WATER ST STE 305
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6566
Mailing Address - Country:US
Mailing Address - Phone:207-872-5610
Mailing Address - Fax:207-660-9901
Practice Address - Street 1:177 N MAIN ST
Practice Address - Street 2:
Practice Address - City:STRONG
Practice Address - State:ME
Practice Address - Zip Code:04983-3005
Practice Address - Country:US
Practice Address - Phone:207-684-3045
Practice Address - Fax:207-684-3049
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH3651124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist