Provider Demographics
NPI:1225042286
Name:STEPHEN A. BEELER, D.D.S., P.A.
Entity Type:Organization
Organization Name:STEPHEN A. BEELER, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-741-2808
Mailing Address - Street 1:127 W INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2205
Mailing Address - Country:US
Mailing Address - Phone:870-741-2808
Mailing Address - Fax:870-741-2812
Practice Address - Street 1:127 W INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2205
Practice Address - Country:US
Practice Address - Phone:870-741-2808
Practice Address - Fax:870-741-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR24611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR58709OtherBCBS PROVIDER