Provider Demographics
NPI:1497948772
Name:BEAUGEZ, JONATHAN E (DMD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:E
Last Name:BEAUGEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 GOVERNMENT ST.
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564
Mailing Address - Country:US
Mailing Address - Phone:228-215-1320
Mailing Address - Fax:228-215-1319
Practice Address - Street 1:2223 GOVERNMENT ST.
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564
Practice Address - Country:US
Practice Address - Phone:228-215-1320
Practice Address - Fax:228-215-1319
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3433-071223G0001X
MS3433071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice