Provider Demographics
NPI:1346232279
Name:BEESON, WILLIAM E (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:BEESON
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 1:2815 W ELK AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1574
Mailing Address - Country:US
Mailing Address - Phone:580-252-7502
Mailing Address - Fax:580-252-4652
Practice Address - Street 1:2815 W ELK AVE
Practice Address - Street 2:SUITE B
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1574
Practice Address - Country:US
Practice Address - Phone:580-252-7502
Practice Address - Fax:580-252-4652
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK44541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice