Provider Demographics
NPI:1558390989
Name:BEACH, CHRISTOPHER LOREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:LOREN
Last Name:BEACH
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 1:1995 COUNTY ROAD 1
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2833
Mailing Address - Country:US
Mailing Address - Phone:727-736-1111
Mailing Address - Fax:
Practice Address - Street 1:1995 COUNTY ROAD 1
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-2833
Practice Address - Country:US
Practice Address - Phone:727-736-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN175241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice