Provider Demographics
NPI:1407847304
Name:BEUTLER, WILLIAM ARNOLD (DMD PC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ARNOLD
Last Name:BEUTLER
Suffix:
Gender:M
Credentials:DMD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-2448
Mailing Address - Country:US
Mailing Address - Phone:503-656-5501
Mailing Address - Fax:503-656-4424
Practice Address - Street 1:205 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-2448
Practice Address - Country:US
Practice Address - Phone:503-656-5501
Practice Address - Fax:503-656-4424
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR37201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice