Provider Demographics
NPI:1538126602
Name:BEAN, CHRISTOPHER LOUIS (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LOUIS
Last Name:BEAN
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 1:2913 OVERLAND TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-4493
Mailing Address - Country:US
Mailing Address - Phone:903-868-8506
Mailing Address - Fax:903-868-9655
Practice Address - Street 1:2913 OVERLAND TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-4493
Practice Address - Country:US
Practice Address - Phone:903-868-8506
Practice Address - Fax:903-868-9655
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX152861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice