Provider Demographics
NPI:1265862544
Name:BEASLEY, CALE PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:CALE
Middle Name:PATRICK
Last Name:BEASLEY
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 1:3498 E ELLSWORTH AVE UNIT 307
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2964
Mailing Address - Country:US
Mailing Address - Phone:417-414-4996
Mailing Address - Fax:
Practice Address - Street 1:5622 S DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5408
Practice Address - Country:US
Practice Address - Phone:303-794-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013030955122300000X
CO202684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist