Provider Demographics
NPI:1376573634
Name:BEEBE, ROBERT WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:BEEBE
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:PO BOX 850
Mailing Address - Street 2:31 PORTLAND RD.
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-0850
Mailing Address - Country:US
Mailing Address - Phone:207-657-3553
Mailing Address - Fax:207-657-2677
Practice Address - Street 1:31 PORTLAND RD.
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-0850
Practice Address - Country:US
Practice Address - Phone:207-657-3553
Practice Address - Fax:207-657-2677
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME24861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice