Provider Demographics
NPI:1518177963
Name:BELYEU, LEXINGTON MAUND (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEXINGTON
Middle Name:MAUND
Last Name:BELYEU
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 1:106 S SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-2057
Mailing Address - Country:US
Mailing Address - Phone:229-336-0898
Mailing Address - Fax:229-336-0106
Practice Address - Street 1:106 S SCOTT ST
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-2057
Practice Address - Country:US
Practice Address - Phone:229-336-0898
Practice Address - Fax:229-336-0106
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0108331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice